Clinical outcomes of pneumococcal pneumonia caused by antibiotic-resistant strains in asian countries: a study by the Asian Network for Surveillance of Resistant Pathogens.
To evaluate the clinical outcomes of pneumococcal pneumonia caused by antibiotic-resistant strains in Asian countries, we performed a prospective observational study of 233 cases of adult pneumococcal pneumonia in 9 Asian countries from January 2000 to June 2001. Among 233 isolates, 128 (55%) were not susceptible to penicillin (25.3% were intermediately susceptible, and 29.6% were resistant). Clinical severity of pneumococcal pneumonia was not significantly different between antibiotic-resistant and antibiotic-susceptible groups. Mortality rates among patients with pneumococcal pneumonia caused by penicillin-, cephalosporin-, or macrolide-resistant strains were not higher than those with antibiotic-susceptible pneumococcal pneumonia. Bacteremia and mechanical ventilation were significant risk factors for death, but any kind of antibiotic resistance was not associated with increased mortality due to pneumococcal pneumonia. Outcome of pneumococcal pneumonia was not significantly affected by drug resistance, and current antimicrobial regimens are mostly effective in the treatment of pneumococcal pneumonia, despite the widespread emergence of in vitro resistance.
Song
Jae-Hoon
JH
Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jhsong@ansorp.org
Jung
Sook-In
SI
Ki
Hyun Kyun
HK
Shin
Myung-Hee
MH
Ko
Kwan Soo
KS
Son
Jun Seong
JS
Chang
Hyun-Ha
HH
Kim
Shin Woo
SW
Lee
Hyuck
H
Kim
Yeon-Sook
YS
Oh
Won Sup
WS
Peck
Kyong Ran
KR
Chongthaleong
Anan
A
Lalitha
M K
MK
Perera
Jennifer
J
Yee
Ti Teow
TT
Jamal
Farida
F
Kamarulzaman
Adeeba
A
Carlos
Celia C
CC
So
Thomas
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia / Q000453:epidemiology; D018550:Cephalosporin Resistance; D002511:Cephalosporins / Q000378:metabolism* / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000401:mortality; D005260:Female; D006801:Humans; D018942:Macrolides / Q000378:metabolism / Q000627:therapeutic use; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010403:Penicillin Resistance; D010406:Penicillins / Q000378:metabolism* / Q000627:therapeutic use; D011018:Pneumonia, Pneumococcal / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality; D011159:Population Surveillance / Q000379:methods*; D011446:Prospective Studies; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification / Q000378:metabolism; D016896:Treatment Outcome
D002511:Cephalosporins; D018942:Macrolides; D010406:Penicillins