Surge in multidrug-resistant S. Pneumonia predicted

The first study to mathematically predict the rising rate of drug-resistant strains of Streptococcus Pneumoniae has concluded that half of the strains of the microorganism will be resistant to both penicillin and erythromycin by next summer.

When you lose two major classes of antimicrobials at the same time, this is clearly a disaster in the making, according to Professor of pharmacy at the University of Kentucky College of Pharmacy, Lexington. He added that there is a need to educate both the public and prescribing clinicians about what the over prescribing of antimicrobial agents is doing.

Antimicrobial restriction and careful use are applicable in the hospital, nursing home and community.

The study, published in the March 10, 2003 online edition of Nature Medicine, used a mathematical transmission model to predict that 41 percent of S. pneumoniae strains will be dually resistant by July 1, 2004.

More cautious use of antimicrobials in some areas of the country explained the variation.

In February, the Food and Drug Administration published a final rule outlining new labeling regulations designed to help reduce the development of drug-resistant bacterial strains.

A recent workshop sponsored by the Centers for Disease Control and Prevention (CDC) and the National Foundation for Infectious Diseases made recommendations that hospitals should monitor antimicrobial use in an attempt to reduce the emergence and spread of antimicrobial-resistant pathogens.

Such monitoring also can aid the infection control community in determining how to focus their efforts toward the same goal. The growing rate of resistance has been noted with increasing alarm since the beginning of the 1990s.

In 1995, the CDC’s National Nosocomial infections Surveillance System reported that the rate of vancomycin-resistant Enterococcus (VRE) increased from 0.3 percent to 7.9 percent.

This overall increase primarily reflected the 34-fold increase in the percentage of VRE infections in patients in ICUs, from 0.4 percent to 13.6 percent. At that time, the occurrence of VRE was associated with larger hospital size-over 200 beds-and university affiliation.