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Update in Infectious Diseases
- John G. Bartlett, MD
- Drug resistance, microbial
- Food microbiology
- Biological warfare
- Communicable diseases
- Human immunodeficiency virus infections
- Antiviral agents
1999-2000 Series: Update Sessions from ACP-ASIM's 1999 Annual Session
Margaret Ring Gillock, Editor, and David Cramer, MD, Co-Editor
An uninterrupted flow of new information and new concepts makes infectious diseases one of the fastest-changing fields of clinical medicine. The emergence of antibiotic-resistant organisms, notably gram-positive cocci, continues unabated. Food-borne disease is also a continuing problem. Among the major culprits are Listeria species, Escherichia coli O157, and Salmonella species, and Cyclospora species have made a dramatic return. The role of irradiation in preventing food-borne illness has been discussed, as have the vital issues posed by bioterrorism. A most exciting prospect is the potential role that certain treatable bacterial infections may play in coronary heart disease and resultant acute myocardial infarction. For influenza, always a hot topic, inhaled antiviral agents are proving effective. Finally, advances in understanding and managing HIV infection merit renewed attention each year.
Antimicrobial Resistance and Prescribing Practices
In addition to pneumococci, emerging resistant strains of Staphylococcus aureus and Salmonella species demand attention. Such resistance is intimately related to prevailing prescribing practices.
Broad-Spectrum Resistance of Streptococcus pneumoniae Continued To Increase in the United States and Canada
Doern GV, Pfaller MA, Kugler K, et al. Prevalence of antimicrobial resistance among respiratory tract isolates of Streptococcus pneumoniae in North America: 1997 results from the SENTRY antimicrobial surveillance program. Clin Infect Dis. 1998; 27:764-70.
Pneumococci are the major treatable pathogens in many of the common infections that account for an impressive share—perhaps 50% to 60%—of all antibiotic prescriptions. Otitis is the major indication in pediatric practice, whereas in adults, Streptococcus pneumoniae is the major pathogen identified in sinusitis, exacerbations of chronic bronchitis, and pneumonia. Doern and colleagues, in the most recent report from SENTRY, a multinational antimicrobial surveillance program, examined resistance patterns of Streptococcus pneumoniae in more than 1000 respiratory tract isolates from 27 centers in the United States and 7 in Canada. Resistance rates of 10% to 20% were documented …
