title: Clinical outcomes of pneumococcal pneumonia caused by antibiotic-resistant strains in asian countries: a study by the Asian Network for Surveillance of Resistant Pathogens.
abstract: 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.
authors.affiliation: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jhsong@ansorp.org
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Song
authors.forename: Sook-In
authors.initials: SI
authors.lastname: Jung
authors.forename: Hyun Kyun
authors.initials: HK
authors.lastname: Ki
authors.forename: Myung-Hee
authors.initials: MH
authors.lastname: Shin
authors.forename: Kwan Soo
authors.initials: KS
authors.lastname: Ko
authors.forename: Jun Seong
authors.initials: JS
authors.lastname: Son
authors.forename: Hyun-Ha
authors.initials: HH
authors.lastname: Chang
authors.forename: Shin Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Hyuck
authors.initials: H
authors.lastname: Lee
authors.forename: Yeon-Sook
authors.initials: YS
authors.lastname: Kim
authors.forename: Won Sup
authors.initials: WS
authors.lastname: Oh
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.forename: Anan
authors.initials: A
authors.lastname: Chongthaleong
authors.forename: M K
authors.initials: MK
authors.lastname: Lalitha
authors.forename: Jennifer
authors.initials: J
authors.lastname: Perera
authors.forename: Ti Teow
authors.initials: TT
authors.lastname: Yee
authors.forename: Farida
authors.initials: F
authors.lastname: Jamal
authors.forename: Adeeba
authors.initials: A
authors.lastname: Kamarulzaman
authors.forename: Celia C
authors.initials: CC
authors.lastname: Carlos
authors.forename: Thomas
authors.initials: T
authors.lastname: So
mesh_terms: 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
chemical_list: D002511:Cephalosporins; D018942:Macrolides; D010406:Penicillins