Evidence map›Paper›PMID 41140274›Full record

ArticleThe Journal of antimicrobial chemotherapy2025

Antimicrobial resistance among agents of community-associated lower respiratory tract infection in the UK and Ireland: trends from 1999/2000 to 2018/2019.

Rosy Reynolds, David Felmingham, Shazad Mushtaq, Carolyne Horner, Aiysha Chaudhry, Rachael Adkin, Michael Allen, Christopher Longshaw, Benjamin J Parcell, David M Livermore

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Rosy ReynoldsPopulation Health Sciences, University of Bristol, Bristol BS8 2PS, UK.
David FelminghamHammerfest, Arrow Lane, Hartley Wintney RG27 8LR, UK.
Shazad MushtaqAntimicrobial Resistance and Healthcare Associated Infections Reference Unit, UK Health Security Agency, Colindale, London NW9 5EQ, UK.ORCID 0000-0002-3908-8332
Carolyne HornerBritish Society for Antimicrobial Chemotherapy, 53 Regent Place, Birmingham B1 3NJ, UK.
Aiysha ChaudhryAntimicrobial Resistance and Healthcare Associated Infections Reference Unit, UK Health Security Agency, Colindale, London NW9 5EQ, UK.
Rachael AdkinAntimicrobial Resistance and Healthcare Associated Infections Reference Unit, UK Health Security Agency, Colindale, London NW9 5EQ, UK.
Michael AllenBritish Society for Antimicrobial Chemotherapy, 53 Regent Place, Birmingham B1 3NJ, UK.
Christopher LongshawBritish Society for Antimicrobial Chemotherapy, 53 Regent Place, Birmingham B1 3NJ, UK.ORCID 0000-0002-5586-7256
Benjamin J ParcellDivision of Population Health and Genomics, School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
David M LivermoreAntimicrobial Resistance and Healthcare Associated Infections Reference Unit, UK Health Security Agency, Colindale, London NW9 5EQ, UK.

Funding

British Society for Antimicrobial Chemotherapy
6 · The paper itself

Abstract

objectivesThe BSAC Respiratory Surveillance Programme examined resistance trends among Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis from patients with community-acquired lower respiratory tract infection (CA-LRTI).

methodsQuotas of isolates were sought per collecting site from 1999/00 to 2018/19; an annual October start date captured winter infection peaks within single years. MIC testing was by BSAC agar dilution. β-Lactamase detection with nitrocefin and pneumococcal serotyping by classical methods or WGS.

resultsResistances were uncommon, except that β-lactamases occurred in c. 20% of H. influenzae from 2012/13 following earlier rises, and in >90% of M. catarrhalis throughout. Only 0.11% (12/10881) of S. pneumoniae were fully resistant to penicillin; co-amoxiclav inhibited 97.8% of 13526 H. influenzae and >99.9% of 6309 M. catarrhalis isolates. Cefotaxime inhibited >99% of all isolates at breakpoint, as did relevant fluoroquinolones in the fewer years tested. Tetracycline inhibited >98% of H. influenzae and M. catarrhalis and 85% of S. pneumoniae. Significant shifts were: (i) fluctuating resistances to tetracyclines, macrolides and penicillin in pneumococci, reflecting serotype replacements; (ii) expansion, from 2012/13, in the proportion of H. influenzae with β-lactamase-independent amoxicillin/co-amoxiclav resistance; and (iii) increasing high-level amoxicillin resistance (MIC  > 64 mg/L) among β-lactamase-positive H. influenzae. MIC differentials were seen for cephalosporins between β-lactamase-positive and β-lactamase-negative M. catarrhalis, greatest (512-fold) for ceftaroline.

conclusionsCA-LRTI remains eminently treatable, yet shifts are occurring in the serotypes of S. pneumoniae most associated with resistance and in the nature of amoxicillin resistance in H. influenzae. β-Lactamase-related cephalosporin MIC differentials for M. catarrhalis are striking but their clinical significance remains uncertain.

Indexed as

Anti-Bacterial AgentsCommunity-Acquired InfectionsDrug Resistance, BacterialRespiratory Tract InfectionsAdolescentAdultAgedbeta-LactamasesChildChild, PreschoolFemaleHaemophilus influenzaeHumansInfantIrelandMaleAnti-Bacterial Agentsbeta-Lactamases

Identifiers

PMID41140274
PMCPMC12555909

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.