Skip to main content
Log in

Antibacterial resistance

  • Symposium on Infections-Old and New-II
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Resistance to antimicrobial agents, whicl was recognized more than 50 years, continues to be a major cause of increased morbidity, mortality and health care cost. Overuse of antibiotics is considered the major contributing factor; however, poor implementation of infection control measures, prolonged hospitalization, admission to intensive care units and the use of invasive procedures are other contributing factors. The authors review the epidemiology, mechanism of resistance, treatment options and prevention measures of infections caused multi-drug resistant S.pneumoniae, methicillin-resistantS. aureus (MRSA), macrolide-resistantS. pyogenes and vancomycin-resistant enterococci (VRE) in pediatric patients. Antibacterial resistance among Gram-negative organisms, including extended spectrum beta-lactamase (ESBL) producing enteric bacteria, and the management and prevention of infections caused by these organisms are also discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Richet HM, Mohammed J, McDonald LC, Jarvis WR. Building communication networks: international network for the study and prevention of emerging antimicrobial resistance.Emerg Infect Dis 2001; 7(2): 319–322.

    PubMed  CAS  Google Scholar 

  2. Hooton TM, Levy SB. Antimicrobial resistance: a plan of action for community practice.Am Fam Physician 2001; 63(6): 1087–1098

    PubMed  CAS  Google Scholar 

  3. Herold BC, Immergluck LC, Maranan MCet al. Communityacquired methicillin-resistantStaphylococcus aureus in children with no identified predisposing risk.Jama 1998 279(8): 593–598.

    Article  PubMed  CAS  Google Scholar 

  4. Levy SB. Antibiotic and antiseptic resistance: impact on public health.Pediatr Infect Dis J 2000; 19(10 Supple) S120–122.

    PubMed  CAS  Google Scholar 

  5. Shlaes DM, Gerding DN, John JFet al. Society for Healthcare Epidemiology for America and Infectious Diseases Society of America Joint Committee on the Prevention of Antimicrobial Resistance: Guidelines for the Prevention of Antimicrobial Resistance in Hospitals.Infection Control and Hosp Epidemiol 1997; 18:275–291.

    CAS  Google Scholar 

  6. CDC Issues in Healthcare Settings. Antimicrobial Resistance : A growing threat to public health. June 1999.

  7. CDC MMWR WeeklyStaphylococcus aureus Resistant to Vancomycin United States 2002; 51:565–567.

    Google Scholar 

  8. CDC MMWR Weekly. Public Health Dispatch: Vancomycin-ResistantStaphylococcus aureus… Pennsylvania 2002; 51: 902

    Google Scholar 

  9. MMWR. Preventing pneumococcal diseases among infants and young children. Recommendations of the Advisory Committee on Immunization Practices (ACIP). Oct. 6, 2000, Vol 49/No. RR-9.

  10. Whitney CG, Farley MM, Hadler Jet al. Increasing prevalence of multidrug-resistantStreptococcus pneumoniae in the United States.N Eng J Med 2000; 343(26): 1917–1924.

    Article  CAS  Google Scholar 

  11. CDC Active Bacterial Core Surveillance (ABCs) Report Emerging Infections Program NetworkStreptococcus pneumoniae, 2000. June 2001.

  12. Levine OS, Farley M, Harrison Het al. Risk factors for invasive pneumococcal disease in children: A population-based casecontrol study in North America.Pediatrics 1999; 102(3): E28.

    Article  Google Scholar 

  13. Peter G, Klein JO.Streptococcus pneumoniae. In Long SS, Pickering LK, Prober CG, eds.Principles and Practice of Pediatric Infectious Diseases, 2nd edn. Chapter 131. 739–746.

  14. Hyde T, Gay K, Stephens DSet al. Macrolide resistance among invasive Streptococcus pneumoniae isolates.JAMA 2001; 286(15): 1857–1862.

    Article  PubMed  CAS  Google Scholar 

  15. Sutcliffe J, Tait-Kamradt A, Wondrack L.Streptococcus pneumoniae andStreptococcus pyogenes resistant to macrolides but sensitive to clindamycin: a common resistance pattern mediated by an Efflux System.Antimicrobiol Agents Chemother 1996; 40 (8): 1817–1824.

    CAS  Google Scholar 

  16. Johnston NJ, de Azavedo J, Kellner JD, Low De. Prevalence and characterization of the mechanisms of macrolide, lincosamide, and streptogramin resistance in isolates ofStreptococcus pneumoniae.Antimicrob Agents Chemother 1998; 42(9): 2425–2426.

    PubMed  CAS  Google Scholar 

  17. Schreiber JR, Jacobs MR. Antibiotic-resistant pneumococci.Pediatric Clin of North America 1995; 42: 519–537.

    CAS  Google Scholar 

  18. Maskell JP, Sefton AM, Hall LM. Multiple mutations modulate the function of Dihydrofolate Reductase in TrimethoprimresistantStreptococcus pneumoniae.Antimicrob Agents Chemother 2001; 45(4): 1104–1108.

    Article  PubMed  CAS  Google Scholar 

  19. Brueggemenn AB, Coffman SL, Rhomberg Pet al. Fluoroquinolone resistance inStreptococcus pneumoniae in United States since 1994–1995.Antimicrob Agent Chemother 2001; 46(3): 680–688.

    Article  CAS  Google Scholar 

  20. Normark BH, Novak R, Ortqvist Aet al. Clinical isolates ofStreptococcus pneumoniae that exhibit tolerance of Vancomycin.Clin Infect Dis 2001; 32: 552–558.

    Article  PubMed  CAS  Google Scholar 

  21. McCullers JA, English BK, Novak R. Isolation and characterization of Vancomycin-tolerantStreptococcus pneumoniae from the cerebrospinal fluid of a patient who developed recrudescent meningitis.J Infect Dis 2000; 18: 369–373.

    Article  Google Scholar 

  22. Dowell SF, Butler JC, Giebink GSet al. Acute otitis media: management and surveillance in an era of pneumococcal resistance — a report from The Drug-resistantStreptococcus pneumoniae Therapeutic Working Group.Pediatr Infect Dis J 1999; 18:1–9.

    Article  PubMed  CAS  Google Scholar 

  23. Red Book 2003 Report of the Committee on Infectious Diseases, 26th ed.Pneumococcal Infections 2003; 490–500.

  24. Nyquist AC, Bonazales R, Steiner JF, Sande MA. Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis.JAMA 1998; 279: 875–877.

    Article  PubMed  CAS  Google Scholar 

  25. Moreira BM, Saum RS. Antimicrobial resistance in staphylococci.Pediatric Clin of North America 1995; 42:619–648.

    CAS  Google Scholar 

  26. Paradisi F, Corti G, Messeri D. Antibiotic Therapy. Antistaphylococcal (MSSA, MRSA, MSSE, MRSE) antibiotics.Med Clin North America 2001; 85:1–17.

    Article  CAS  Google Scholar 

  27. Red Book 2003 Report of the Committee on Infectious Diseases, 26th ed.Staphylococcal Infections 2003; 561–573.

  28. CDC. Four pediatric deaths from community-acquired methicillin-resistantStreptococcus aureus — Minnesota and North Dakota, 1997–1999.MMWR 1999; 20: 707–710.

    Google Scholar 

  29. Herold BC, Immergluck LC, Maranan MCet al. Communityacquired methicillin-resistantStreptococcus aureus in children with no identified predisposing risk.Jama 1998; 279: 593–598.

    Article  PubMed  CAS  Google Scholar 

  30. Salmenlinna S, Lyytikainen O, Vuopio-Varkila J. Communityacquired methicillin-resistantStreptococcus aureus, Finland.Emerg Infect Dis 2003; 9(2): 169–175.

    PubMed  Google Scholar 

  31. Sattler CA, Mason EO, Kaplan SL. Prospective comparison of risk factors and demographic and clinical characteristics of community-acquired, methicillin-resistant versus methicillinsusceptibleStreptococcus aureus infection in children.Pediatr Infect Dis J 2002; 21: 910–916.

    Article  PubMed  Google Scholar 

  32. Gorak EJ, Yamada SM, Brown JD. Community-acquired methicillin-resistantStreptococcus aureus in hospitalized adults and children without known risk factors.Clin Infect Dis 1999; 29:797–800.

    PubMed  CAS  Google Scholar 

  33. Frank AL, Marcinak JF, Mangat PDet al. Clindamycin treatment of methicillin-resistantStreptococcus aureus infections in children.Pediatr Infect Dis J 2002; 21:530–534.

    Article  PubMed  Google Scholar 

  34. Georgopapadakou N. Mechanisms of antibiotic resistance. In Long SS, Pickering LK, Prober CG, eds.Principles and Practice of Pediatric Infectious Diseases, 2nd edn. 2003; 1432–1443.

  35. Frank AL, Marcinak JF, Mangat PDet al. Community-acquired and clindamycin susceptible methicillin-resistantStreptococcus aureus in children.Pediatr Infect Dis J 1999; 18: 993–1000.

    Article  PubMed  CAS  Google Scholar 

  36. Kaplan SL. Treatment ofStreptococcus aureus bacteremia in children.Up to Date Online 11.1.2003.

  37. Red Book 2003 Report of the Committee on Infectious Diseases, 26th ed.Staphylococcal Infections. 2003; 561–573.

  38. CDC. Issues in Healthcare Settings. VISA/VRSA — Vancomycin-intermediate/resistantStreptococcus aureus. Fact Sheet.

  39. Fridkin SK, Hegeman J, McDougal LKet al. Epidemlological and microbiological characterization of infections causes byStaphylococcus aureus with reduced susceptibility to vancomycin, United States, 1997–2001.Clin Infect Dis 2003; 36:429–439.

    Article  PubMed  Google Scholar 

  40. Tenover FC, Biddle JW, Lancaster MV. Increasing resistance to vancomycin and other glycopeptides inStreptococcus aureus.Emerg Infect Dis 2001; 7: 327–332.

    PubMed  CAS  Google Scholar 

  41. CDC MMWR Weekly.Streptococcus aureus resistant to vancomycin-United States, 2002. July 5, 2002/51(26); 656–567.

    Google Scholar 

  42. CDC MMWR Weekly. Public Health Dispatch: VancomycinresistantStreptococcus aureus —Pennsylvania, 2002. October 11, 2002; 51(40): 902.

    Google Scholar 

  43. Chesney PJ.Streptococcus aureus. Long SS, Pickering LK, Prober CG, eds.Principles and Practice of Pediatric Infectious Diseases, 2nd edn. 2003 Chapter 122, p. 694–706.

  44. Kluytmans J, van Belkum A. Verbrugh H. Nasal carriage ofStreptococcus aureus: Epidemiology, underlying mechanisms, and associated risks.Clin Microbiol Res 1997; 10 : 505–520.

    CAS  Google Scholar 

  45. Yu VL, Geotz A, Wagener Met al. Streptococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis.N Eng J Med 1986; 315:91–96.

    Article  CAS  Google Scholar 

  46. Fines M, Gueudin M, Ramon A, Lecllercq R.In vitro selection of resistance to clindamycin related to alterations in the attenuator of the erm (TR) gene ofStreptococcus aureus UCN inducibly resistant erythromycin.J Antimicrobial Chemother 2001; 48:411–416.

    Article  CAS  Google Scholar 

  47. Rondini G, Cocuzza CE, Cianflone Met al. Bacteriological and clinical efficacy of various antibiotics used in the treatment of streptococcal pharyngitis in Italy. An epidemiological study.International J Antimicrob Agents 2001; 18:9–17.

    Article  CAS  Google Scholar 

  48. Cizman M, Pokorn M, Seme K, Orazem A, Paragi M. The relationship between trends in macrolide use and resistance of macrolides of common respiratory pathogens.J Antimicrob Chemothr 2001; 47:475–477.

    Article  CAS  Google Scholar 

  49. Martin JM, Green M, Barbadora KA, Wald ER. Erythromycinresistant group A Streptococci in schoolchildren in Pittsburgh.N Engl J Med 2002; 346(16): 1200–1206.

    Article  PubMed  Google Scholar 

  50. Shulman ST, Tanz R, Kabat W. Letter to the Editor.N Engl J MED 2002; 347: 613–622.

    Article  Google Scholar 

  51. Jasir A, Tanna A, Noorani Aet al. High rate of tetracycline resistant inStreptococcus pyogenes in Iran: an epidemiological study.J Clin Microbiol 2000; 38(6) : 2103–2107.

    PubMed  CAS  Google Scholar 

  52. Rice LB, Shlaes DM. Vancomycin resistance in the enterococcus. Relevance in Pediatrics.Pediatric Clin of North America 1995; 42:601–617.

    CAS  Google Scholar 

  53. Linden PK. Treatment options for vancomycin-resistant enterococcal infections.Drug 2002; 62:425–441.

    Article  CAS  Google Scholar 

  54. Dobson SRM, Baker CJ. Enterococcal sepsis in neonates: Features by age at onset and occurrence of focal infection.Pediatrics 1990; 85:165–171.

    PubMed  CAS  Google Scholar 

  55. Eliopoulos GM. Antibiotic resistance in Enterococcus species: An update.Curr Clin Top Infect Dis 1996; 16: 21–51.

    PubMed  CAS  Google Scholar 

  56. CDC Nosocomial enterococci resistant to vancomycin — United States, 1989–1993.MMWR 2003; 42(30) : 579–599.

  57. Mutnick AH, Enne V, Jones RN. Linezolid-resistance since 2001: Sentry Antimicrobial Surveillance Program.Ann Pharmacother 2003; 37(6) : 769–774.

    Article  PubMed  CAS  Google Scholar 

  58. Werner G, Klare I, Spencker FB, Witte W. Intra-hospital dissemination of quinupristin/dalfoprism-and vancomycinresistant Enterococcus faecium in a pediatric ward of a German hospital.J Antimicrob Chemother 2003; 52(1): 113–115.

    Article  PubMed  CAS  Google Scholar 

  59. Chon CH, Pediatric urinary tract infection.The Pediatric Clinics of North America 2001; 48:1441–1459.

    Article  CAS  Google Scholar 

  60. Iwalokun BA, Gbenle GO, Smith SIet al. Epidemiology of shigellosis in Lagos, Nigeria: Trends in Antimicrobial Resistance.J Health Popul Nutr 2001; 19(3) : 183–190.

    PubMed  CAS  Google Scholar 

  61. Red Book 2003 Report of the Committee on Infectious Diseases, 26th edn.Shigella Infections p. 551–553.

  62. Dunne EF, Fey PD, Kludt Pet al. Emergence of domestically acquired ceftriaxone-resistant Salmonella infections associated with AmpC Β-lactamase.JAMA 2000; 284:3151–3156.

    Article  PubMed  CAS  Google Scholar 

  63. Gales AC, Sader HS, Mendes RE, Jones RN. Salmonella spp. isolates causing bloodstream infections in Latin America: report of antimicrobial activity from the SENTRY Antimicrobial Surveillance Program (1997–2000).Diagn Microbiol Infect Dis 2002; 44 (3) : 313–318.

    Article  PubMed  Google Scholar 

  64. Graham SM, Molyneux EM, Walsh ALet al. Nontyhoidal Salmonella infections of children in tropical Africa.Pediatr Infect Dis J 2000; 19:1189–1196.

    Article  PubMed  CAS  Google Scholar 

  65. Glynn MK, Bopp C, Dewit Wet al. Emergence of multidrugresistant Salmonella enterica serotype typhimurium DT 104 infections in the United States.N Engl J Med 1998; 338:1333–1338.

    Article  PubMed  CAS  Google Scholar 

  66. Burns JL. Mechanisms of bacterial resistance.Pediatr Clin of North America 1995; 42(3): 479–507.

    Google Scholar 

  67. Mandell. In Mechanisms of Antibiotic Resistance. Principle and Practice of Infectious Diseases, 5th ed. Churchill Livingstone, Inc., 2000.

  68. Thomson KS. Controversies about extended-spectrum and AmpC beta-lactamases.Emerg Infect Dis 2001; 7(2): 333–336.

    Article  PubMed  CAS  Google Scholar 

  69. Kaye KS, Fraimow HS, Abrutyn E. Pathogens resistant to antimicrobial agents. Epidemiology, molecular mechanisms, and clinical management.Infect Dis Clin of North America 2000; 14:293–319.

    Article  CAS  Google Scholar 

  70. Patterson JE. Extended spectrum beta-lactamases: a therapeutic dilemma.Pediatr Infect Dis J 2002; 21(10): 957–960.

    Article  PubMed  Google Scholar 

  71. Mathai D, Rhomberg PR, Biedenbach DJ, Jones RN. The India Antimicrobial Resistance Study Group. Evaluation of the invitro activity of six broad-spectrum B-lactam antimicrobial agents tested against recent clinical isolates from India: a survey of ten medical center laboratories.Diagn Microbiol Infect Dis 2002; 44; 367–377.

    Article  PubMed  CAS  Google Scholar 

  72. Paterson DL, Ko WC, Gottberg AVet al. Outcome of cephalosporin treatment for serious infections due to apparently susceptible organism producing extendedspectrum B-lactamases: Implications for the clinical microbiology laboratory.J Clin Microbiol 2001; 39(6) : 2206–2212.

    Article  PubMed  CAS  Google Scholar 

  73. Bonfiglio G, Perilli M, Stafani S, Amicosante G, Nicoletti G. Prevalence of extended spectum \-lactameses among enterobacteriaceau: an Italian survey.Internat J Antimicrob Agents 2002; 19 :213–217.

    Article  CAS  Google Scholar 

  74. Shears P. A review of bacterial resistance to antimicrobial agents in tropical countries.Annals of Tropical Paediatrics 1993; 13:219–226.

    PubMed  CAS  Google Scholar 

  75. Green S, Tillotson G. Use of ciprofloxacin in developing countries.Pediatr Infect Dis J 1997; 16(1): 150–159.

    Article  PubMed  CAS  Google Scholar 

  76. Niyogi SK, Dutta P, Mitra U. Trends in antimicrobial resistance of Shigella Species isolated from children with acute diarrhea. Letter to the Editor.Indian Pediatrics 2000; 37: 296–307.

    Google Scholar 

  77. Gomez, HF, Cleary TG. Shigella Species. In Long SS, Pickering LK, Prober CG, eds.Principle and Practice of Pediatric Infectious Diseases, 2nd edn. 2003; Chapter 156, 836–839.

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ang, J.Y., Ezike, E. & Asmar, B.I. Antibacterial resistance. Indian J Pediatr 71, 229–239 (2004). https://doi.org/10.1007/BF02724275

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02724275

Key words

Navigation