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[Pneumococcal infections in the adult population observed at the Poitiers University Hospital. Epidemiologic and clinical study].

OBJECTIVES: The aim of this study was to assess the prevalence of penicillin-nonsusceptible pneumococcus (PNSP) infections and their clinical and microbiological features among an adult population hospitalized at the Poitiers University Hospital. PATIENTS AND METHODS: A prospective study was conducted between November 1994 and October 1995 and included all pneumococcus infections. RESULTS: Fifty-three adults with one pneumococcal strain were included. The overall rate of PNSP strains was 28%. Infections with PNSP strains were more resistant than penicillin-susceptible pneumococcus to other antibiotics. The most frequent infection was pneumonia (36 infections, 28% PNSP). DISCUSSION: The rate of PNSP in pneumococcal infections was the same in the Poitiers University Hospital as in national surveys in France. The high percentage of multiresistant strains (86.5%) limit the use of antibiotics other than beta-lactams. Surveys of pneumococcal resistance to antibiotics are needed to adapt antibiotic strategies to the local epidemiological situation.

Adult↗

Impact of Antimicrobial Resistance on the Treatment of Invasive Pneumococcal Infections.

Infectious diseases, such as pneumococcal pneumonia, which were almost invariably lethal in the pre-antibiotic era, caused radically less mortality with the advent of antimicrobial chemotherapy. However, the use, misuse, and abuse of these agents have led to the emergence of antimicrobial resistance. In the past, pneumococci were all exquisitely sensitive to penicillin G. By the late 1960s, penicillin-nonsusceptible Streptococcus pneumoniae (PNSP) was being described. Since then, this problem has achieved epidemic proportions in many areas of the world, including the United States. Many experts no longer consider penicillin an acceptable therapy for patients suspected of having invasive pneumococcal disease, especially if the central nervous system (CNS) is involved. Recommendations for therapy are based on theoretical concerns, in vitro susceptibility testing, animal data, and a few, scattered reports of penicillin failure in patients with invasive disease.

Journal Article↗

Pneumococcal infection in the newborn.

Two fatal cases of invasive pneumococcal disease in the newborn are reported, both acquired from the maternal vagina. The rarity of vaginal carriage of pneumococcus suggests that this organism has a higher invasion to colonisation ratio than group B streptococcus and maternal carriage or neonatal colonisation should be more aggressively treated.

Adult↗

Enhanced protective immunity against pneumococcal infection with PspA DNA and protein.

The effect of priming and boosting with pspA/EF5668 and purified recombinant PspA/EF5668 was examined. With this strategy CBA/N mice were protected against fatal challenge with Streptococcus pneumoniae EF5668. Anti-PspA antibody titers were elevated, and Western analysis with the immune serum demonstrated cross-reactivity with PspA from several different pneumococcal isolates, representing different PspA clades. Immune serum localized cross-reactive epitopes to the alpha-helical domain of PspA/Rx1 and PspA/EF5668. We demonstrated that DNA/protein prime-boost immunizations can enhance protective immunity against pneumococcal challenge.

Animals↗