ArticleInfection2013
Association of levofloxacin resistance with mortality in adult patients with invasive pneumococcal diseases: a post hoc analysis of a prospective cohort.
Article in Infection, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Prognostic factors for mortality in invasive pneumococcal disease in adult: a system review and meta-analysis.Scientific reports · 2021Pooled it
- Estimating the burden of antimicrobial resistance: a systematic literature review.Antimicrobial resistance and infection control · 2018Pooled it
- Trial
- Invasive Pneumococcal Diseases in Korean Adults After the Introduction of Pneumococcal Vaccine into the National Immunization Program.Infection & chemotherapy · 2023Review
- Serotype distribution and antimicrobial resistance of invasive Streptococcus pneumoniae isolates among Croatian adults during a fifteen-year period (2005-2019).Croatian medical journal · 2022Article
- Spread of ceftriaxone non-susceptible pneumococci in South Korea: Long-term care facilities as a potential reservoir.PloS one · 2019Article
- Results from the Survey of Antibiotic Resistance (SOAR) 2012-14 in Thailand, India, South Korea and Singapore.The Journal of antimicrobial chemotherapy · 2016Article
- Clinical importance and epidemiology of quinolone resistance.Infection & chemotherapy · 2014Review
- Recurrent pneumococcal invasive disease in the region of Madrid during a five-year period.Infection · 2014Article
- The comparative development of elevated resistance to macrolides in community-acquired pneumonia caused by Streptococcus pneumoniae.Drug design, development and therapy · 2014Article
- Risk factors for levofloxacin-nonsusceptible Streptococcus pneumoniae in community-acquired pneumococcal pneumonia: a nested case-control study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2014Article
- Risk factors and clinical significance of invasive infections caused by levofloxacin-resistant Streptococcus pneumoniae.Infection · 2013Article
- Antimicrobial resistance in Asia: current epidemiology and clinical implications.Infection & chemotherapy · 2013Review
Corrections and comments
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Authors and funding
14 authors at 10 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study was conducted to identify risk factors for mortality and to evaluate the impact of antimicrobial resistance on outcome in adult patients with invasive pneumococcal disease (IPD).
methodsA post hoc analysis of an observational cohort study on community-acquired pneumococcal infections was conducted and a total of 136 adult patients with IPD were analyzed in this study.
resultsPneumonia was the most common type of infection (n = 84, 61.8 %), followed by primary bacteremia (n = 15, 11.0 %) and meningitis (n = 15, 11.0 %). One hundred and three patients (75.7 %) had concomitant pneumococcal bacteremia. The overall 30-day mortality rate was 26.5 % (36/136), and factors associated with 30-day mortality were corticosteroid use, presentation with septic shock, and development of acute respiratory distress syndrome (ARDS) (all P < 0.05). While penicillin and erythromycin resistance were associated with a lower mortality, an association between levofloxacin resistance and increased mortality was found in the univariate analysis; however, statistical significance was not reached (P = 0.083). Multivariable analysis showed that presentation with septic shock, corticosteroid use, development of ARDS, and levofloxacin resistance were independent factors associated with 30-day mortality. Of the five patients with IPD caused by levofloxacin-resistant Streptococcus pneumoniae, three (60 %) died within 30 days of diagnosis.
conclusionLevofloxacin resistance was associated with increased mortality, along with septic shock, prior use of corticosteroids, and development of ARDS, in adult patients with IPD. Our data suggest that the emergence of levofloxacin resistance among invasive pneumococcal isolates is now becoming a challenge for clinicians managing community-acquired bacterial infections.
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