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          h. Streptococcus pneumoniae

h. Streptococcus pneumoniae

This organism causes more than 800,000 deaths among children younger than 5 years (Saha et al. 2009). Although availability of effective pneumococcal vaccines reduces the prevalence of invasive disease in vaccinated children and those they contact in the home (Hicks et al. 2007; Hicks et al. 2011), recent evidence suggests an upward trend in invasive infections by serotypes that are not covered by available vaccines (Rosen et al. 2011). From 2001 to 2004, 824 consecutive S pneumoniae isolates from all Kuwait teaching hospitals and primary-care centers showed 63% resistance to penicillin (55% were of intermediate resistance and 8% were of full resistance) (Mokaddas et al. 2007). S pneumoniae isolates collected during 2000 to 2004 in the United States showed 29.3%, 21.2%, 0.9%, and 0.02% of isolates to be resistant to erythromycin, penicillin, levofloxacin, and telithromycin, respectively. The proportion of isolates exhibiting multidrug resistance remained stable at ~30% during the 4-year study period (Jenkins et al. 2008). The antimicrobial susceptibility of S pneumoniae isolates from hospitalized children in Bangladesh revealed complete resistance to chloramphenicol and cotrimoxazole in 6% and 32% of patients, respectively (Saha et al. 2009).

Table of Contents

SECTION ONE: The global threat of AMDR
SECTION TWO: Understanding AMDR
    1. Etiology and Epidemiology
    2. Incidence and Prevalence of Microbial Resistance
    3. Major AMDR Pathogens
       a. Acinetobacter baumanii
       b. Clostridium difficile
       c. Escherichia coli
       d. HIV/AIDS and Sexually Transmitted Infection
       e. Influenza virus
       f. Malaria (Plasmodium)
       g. Methicillin-resistant Staphylococcus aureus (MRSA)
       h. Streptococcus pneumoniae
       i. Tuberculosis and MDR-TB
       j. Vancomycin-Resistant Enterococcus (VRE)
SECTION THREE: Control and Prevention of AMDR
    1. Implications of Microbial Resistance
    2. Infections and Chronic Diseases
    3. Policies and Best Practices
       a. Antimicrobial Drug Stewardship
       b. Surveillance
       c. Environmental Decontamination
       d. Infection Control
       e. Patient Education
    4. Antibiotic Development Pipeline
SECTION FOUR: Conclusions
Test Questions
Program Evaluation
Self Assessment

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