ABSTRACT
Streptococcus pneumoniae is a major worldwide bacterial pathogen responsible for a variety of infections including pneumonia, bacteremia, otitis media, meningitis, sinusitis, and other infections. It is the most common pathogen causing bacterial community-acquired pneumonia. Multi-drug resistant S. pneumoniae (MDRSP), defined as resistance to penicillin and at least 2 other antibiotic classes, was first reported from South Africa in 1978. Published surveillance data suggest that approximately 35% to 38% of S. pneumoniae isolates in the United States are penicillin non-susceptible. The prevalence of macrolide resistance has increased markedly in S. pneumoniae. Clinical data indicate that use of older fluoroquinolones against resistant strains of S. pneumoniae results in clinical failure. Not surprisingly, beta-lactam therapy has been identified as a major risk factor for both carriage of and infection with beta-lactam resistant S. pneumoniae in multiple studies. S. pneumoniae is a virulent human pathogen and the benefits of antimicrobial therapy on mortality from bacteremic disease are well known.
