Penicillin resistance in Streptococcus pneumoniae: Threat, Treatment, and Future trends in Management

Emergence of antibiotic resistance is a global concern in this era to combat infectious diseases. Streptococcus pneumoniae is one of the most common causes of communityacquired respiratory tract infections and the drug of choice for treatment was penicillin. However, the first clinically significan...

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Main Authors: Htay, Mila Nu Nu, Myint, Wai Wai, Aranan, Angus E, Htay, Win
Format: Article
Language:English
Published: Gurgaon : Sciencedomain International 2017
Subjects:
Online Access:http://ir.unimas.my/id/eprint/19168/
http://ir.unimas.my/id/eprint/19168/1/Penicillin%20resistant%20S.%20pneumoniae%20%28abstrak%29.pdf
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author Htay, Mila Nu Nu
Myint, Wai Wai
Aranan, Angus E
Htay, Win
author_facet Htay, Mila Nu Nu
Myint, Wai Wai
Aranan, Angus E
Htay, Win
author_sort Htay, Mila Nu Nu
building UNIMAS Institutional Repository
collection Online Access
description Emergence of antibiotic resistance is a global concern in this era to combat infectious diseases. Streptococcus pneumoniae is one of the most common causes of communityacquired respiratory tract infections and the drug of choice for treatment was penicillin. However, the first clinically significant penicillin-non-susceptible pneumococcus (PNSP) was documented in 1967. Since then, penicillin resistance strain had been identified in different continents of the world. Among 94 serotypes of S. pneumoniae, ―paediatric serotypes‖ (6A, 6B, 9V, 14, 15A, 19A, 19F and 23F) were found to have the highest resistance to penicillin and erythromycin globally. The mechanism of penicillin resistance in S. pneumoniae is conveyed by the alternation of the structure of penicillin binding proteins (PBPs), which leads to reducing the affinity for penicillin. There is a relationship between antibiotic consumption and dissemination of antibiotic resistant pneumococcal clones in Southern and Eastern Europe, America, and Asia. Therefore, rational use of antibiotics is important in order to decrease the development and spread of resistant strains. After the introduction of Pneumococcal conjugate vaccine (PCV) 7 vaccines, non-vaccine serotypes like 6C, 11A, 15A, and 15B/C have increased in prevalence. Since the changes in serotype prevalence due to selective pressure have been observed, it is necessary to monitor the prevalent serotypes. Optimal coverage may be achieved by using vaccines with a wide range of serotype coverage in the future. In managing pneumococcal infections, sensitivity tests are important to choose the appropriate antibiotics. In severe pneumonia or hospital-acquired pneumonia patients at the area of high prevalence of PNSP, the initial antibiotics must include intravenous carbapenems, ceftriaxone, cefotaxime or newer quinolones, meanwhile, penicillin-resistant pneumococcal meningitis (≥ 2 µg/ml) is vancomycin and ceftriaxone or cefotaxime. Judicious use of antibiotics, modification of the treatment duration and encouragement for adherence by patients are recommended to prevent antibiotic resistance. Development of new classes of drugs and novel therapeutic regimen is essential to overcome the hazard of penicillin resistance pneumococcal infection in future. Keywords: Penicillin resistance, β-Lactams, Streptococcus pneumoniae, Communityacquired respiratory tract infections.
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spelling unimas-191682018-01-03T05:51:51Z http://ir.unimas.my/id/eprint/19168/ Penicillin resistance in Streptococcus pneumoniae: Threat, Treatment, and Future trends in Management Htay, Mila Nu Nu Myint, Wai Wai Aranan, Angus E Htay, Win RM Therapeutics. Pharmacology Emergence of antibiotic resistance is a global concern in this era to combat infectious diseases. Streptococcus pneumoniae is one of the most common causes of communityacquired respiratory tract infections and the drug of choice for treatment was penicillin. However, the first clinically significant penicillin-non-susceptible pneumococcus (PNSP) was documented in 1967. Since then, penicillin resistance strain had been identified in different continents of the world. Among 94 serotypes of S. pneumoniae, ―paediatric serotypes‖ (6A, 6B, 9V, 14, 15A, 19A, 19F and 23F) were found to have the highest resistance to penicillin and erythromycin globally. The mechanism of penicillin resistance in S. pneumoniae is conveyed by the alternation of the structure of penicillin binding proteins (PBPs), which leads to reducing the affinity for penicillin. There is a relationship between antibiotic consumption and dissemination of antibiotic resistant pneumococcal clones in Southern and Eastern Europe, America, and Asia. Therefore, rational use of antibiotics is important in order to decrease the development and spread of resistant strains. After the introduction of Pneumococcal conjugate vaccine (PCV) 7 vaccines, non-vaccine serotypes like 6C, 11A, 15A, and 15B/C have increased in prevalence. Since the changes in serotype prevalence due to selective pressure have been observed, it is necessary to monitor the prevalent serotypes. Optimal coverage may be achieved by using vaccines with a wide range of serotype coverage in the future. In managing pneumococcal infections, sensitivity tests are important to choose the appropriate antibiotics. In severe pneumonia or hospital-acquired pneumonia patients at the area of high prevalence of PNSP, the initial antibiotics must include intravenous carbapenems, ceftriaxone, cefotaxime or newer quinolones, meanwhile, penicillin-resistant pneumococcal meningitis (≥ 2 µg/ml) is vancomycin and ceftriaxone or cefotaxime. Judicious use of antibiotics, modification of the treatment duration and encouragement for adherence by patients are recommended to prevent antibiotic resistance. Development of new classes of drugs and novel therapeutic regimen is essential to overcome the hazard of penicillin resistance pneumococcal infection in future. Keywords: Penicillin resistance, β-Lactams, Streptococcus pneumoniae, Communityacquired respiratory tract infections. Gurgaon : Sciencedomain International 2017-10-27 Article PeerReviewed text en http://ir.unimas.my/id/eprint/19168/1/Penicillin%20resistant%20S.%20pneumoniae%20%28abstrak%29.pdf Htay, Mila Nu Nu and Myint, Wai Wai and Aranan, Angus E and Htay, Win (2017) Penicillin resistance in Streptococcus pneumoniae: Threat, Treatment, and Future trends in Management. British Journal of Medical and Health Research, 4(10) (10). pp. 1-11. ISSN 2394-2967 http://www.bjmhr.com 2394-2967
spellingShingle RM Therapeutics. Pharmacology
Htay, Mila Nu Nu
Myint, Wai Wai
Aranan, Angus E
Htay, Win
Penicillin resistance in Streptococcus pneumoniae: Threat, Treatment, and Future trends in Management
title Penicillin resistance in Streptococcus pneumoniae: Threat, Treatment, and Future trends in Management
title_full Penicillin resistance in Streptococcus pneumoniae: Threat, Treatment, and Future trends in Management
title_fullStr Penicillin resistance in Streptococcus pneumoniae: Threat, Treatment, and Future trends in Management
title_full_unstemmed Penicillin resistance in Streptococcus pneumoniae: Threat, Treatment, and Future trends in Management
title_short Penicillin resistance in Streptococcus pneumoniae: Threat, Treatment, and Future trends in Management
title_sort penicillin resistance in streptococcus pneumoniae: threat, treatment, and future trends in management
topic RM Therapeutics. Pharmacology
url http://ir.unimas.my/id/eprint/19168/
http://ir.unimas.my/id/eprint/19168/
http://ir.unimas.my/id/eprint/19168/
http://ir.unimas.my/id/eprint/19168/1/Penicillin%20resistant%20S.%20pneumoniae%20%28abstrak%29.pdf