PENICILLIN–RESISTANT STREPTOCOCCUS PNEUMONIAE – A REVIEW

Abstract

Since the first report in 1967, the incidence of Penicillin Resistant Streptococcus pneumoniae (Pneumococcus) has risen steadily worldwide, and now complicates diagnostic and treatment strategies for infections due to this organism. More worrisome is the fact that in areas where Penicillin Resistant Streptococcus pneumoniae (PRSP) has become established, resistance to other antimicrobial agents such as cephalosporins, sulphonamides and macrolides is also common. This development has a grave implication for therapy of life threatening pneumococcal infections like meningitis and septicaemia, with the extended spectrum cephalosporins, such as ceftriaxone and cefotaxime, and the newer macrolides, azithromycin and clarithromycin. The mechanism of resistance to β-lactam antibiotics is decreased binding of drug to the bacteria cell wall brought about by genetic transformation in bacterial chromosome. Recently, using molecular techniques that can index overall relatedness of the drug resistant pneumococcal isolates, it has been possible to establish clonal dissemination of drug resistant pneumococci across continents, with acquisition of additional drug resistance determinants as a result of “local” antibiotic selective pressures. This is a review of literature on the epidemiology, mechanism of resistance, laboratory identification, treatment, prevention and control of Penicillin Resistant Pneumococci (PRP), with emphasis on the problems of identification and reporting in developing countries.


Key Words: penicillin, Streptococcus pneumoniae, resistant, extended spectrum cephalosporins.


African Journal Of Clinical And Experimental Microbiology Jan 2004 Vol.5 No.1 78-107