Comparative Antimicrobial Susceptibility of Respiratory Tract PathogensFelmingham D.
G.R. Micro Ltd., London, UK
Bacterial respiratory tract infections (RTIs), whether primary or subsequent to viral infection, are a frequent cause of morbidity and mortality worldwide. Treatment of these infections is most often empirical. Therefore, an antimicrobial’s antibacterial spectrum must include the most likely pathogens: Streptococcus pneumoniae, the most frequent cause of community-acquired pneumonia (CAP), Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus, as well as atypicals such as Mycoplasma pneumoniae, Legionella pneumophila and Chlamydophila (Chlamydia) pneumoniae. In addition, knowledge of antimicrobial resistance among these key pathogens is imperative for physicians to choose the most appropriate therapeutic agent. The latest data from global surveillance studies indicates that high-level resistance to penicillin (MIC ≧2 mg/l) among isolates of S. pneumoniae varies widely by geographic location. Rates exceed 20% in the USA, Mexico, Japan, Saudi Arabia, Israel, Spain, France, Greece, Hungary, and the Slovak Republic. In South Africa, Hong Kong, Taiwan, and South Korea rates exceed 50%. Penicillin non-susceptibility – including isolates exhibiting high-level resistance and intermediate susceptibility (MIC 0.12–1 mg/l) – is frequently found in association with macrolide resistance, which is found at a prevalence of 70–80% in some Asian countries. Trimethoprim-sulfamethoxazole (TMP-SMX) and tetracycline resistance, either individually or combined with macrolide resistance as multiple resistance, is also associated with reduced susceptibility to penicillin. Another concern about antimicrobial resistance in respiratory tract pathogens is β-lactamase production among isolates of H. influenzae and M. catarrhalis. However, respiratory fluoroquinolones, of which levofloxacin has been available for the longest time, currently remain active against the great majority of common bacterial respiratory pathogens, including atypicals.
Dr. David Felmingham, Chief Executive
GR Micro Ltd., 7–9 William Road
London NW1 3ER (UK)
Tel. +44 20 7388 7320, Fax +44 20 7388 7324
Number of Print Pages : 8
Number of Figures : 6, Number of Tables : 1, Number of References : 19
Chemotherapy (International Journal of Experimental and Clinical Chemotherapy)
Founded 1959 as ‘Chemotherapia’
Vol. 50, No. Suppl. 1, Year 2004 (Cover Date: Released August 2004)
Journal Editor: F. Sörgel, Nürnberg-Heroldsberg
ISSN: 0009–3157 (print), 1421–9794 (Online)
For additional information:http://www.karger.com/che