Trends of penicillin and erythromycin resistance among invasive Streptococcus pneumoniae in Europe
Trends of penicillin and erythromycin resistance among invasive Streptococcus pneumoniae in Europe
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DOI：
10.1093/jac/dkh458
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发表时间：
2004-12-01
影响因子：
5.2
通讯作者：
Grundmann, H
中科院分区：
文献类型：
--
作者：
Bruinsma, N;Kristinsson, KG;Grundmann, H
目的：预测欧洲肺炎链球菌对青霉素和红霉素的耐药趋势。方法：自1999年起，欧洲抗生素耐药性监测系统（EARSS）收集肺炎链球菌常规药敏试验结果。为了观察和预测降低的易感性随时间的变化，我们使用了多项逻辑回归模型。结果：各国之间青霉素和红霉素非敏感性存在较大差异，在整个欧洲，红霉素敏感性降低（17%）比青霉素敏感性降低（10%）更为常见。观察到单一青霉素不敏感的总体下降，但双重不敏感的增加，表明单一青霉素向红霉素联合不敏感的转变。到2006年，单药红霉素和双药不敏感的比例可能分别增加到20.4%和8.9%。结论：我们的结果表明，适当剂量的β -内酰胺类药物仍是经验性治疗的选择，大环内酯类药物应谨慎使用。
Objectives: To forecast trends in resistance to penicillin and erythromycin among Streptococcus pneumoniae in Europe.Methods: Since 1999, the European Antimicrobial Resistance Surveillance System (EARSS) has collected routine antimicrobial susceptibility test results of S. pneumoniae. To observe and predict changes of reduced susceptibility over time, we used a multinomial logistic regression model.Results: Large variations in penicillin and erythromycin non-susceptibility were observed between countries, and reduced susceptibility to erythromycin (17%) has become more frequent than reduced susceptibility to penicillin (10%) in Europe overall. An overall decrease in single penicillin non-susceptibility, but an increase in dual non-susceptibility was observed, indicating a shift of single penicillin to combined non-susceptibility with erythromycin. By 2006, the proportion of single erythromycin and dual non-susceptibility could increase to as much as 20.4% and 8.9%, respectively.Conclusions: Our results indicate that appropriately dosed beta-lactams for empirical therapy are still the treatment of choice, and that macrolides should be used with prudence.