Drug resistance in Streptococcus pneumoniae: Epidemiology and control

M. Kalin*, K. G. Kristinsson

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)


Streptococcus pneumoniae is one of the most important human pathogens. The rapid emergence and global spread of resistance against the most important antibiotics is therefore a serious public health concern. Resistance to β-lactam antibiotics is due to alteration of the penicillin-binding proteins (PBPs), enzymes responsible for cell wall synthesis. This alteration implies reduced affinity for penicillin and also for other β-lactam drugs, but to a different extent. Under the influence of antibiotic selective pressure, increase in resistance prevalence is due to (1) horizontal transfer of low-affinity PBP gene segments from closely related α-haemolytic streptococci by natural transformation, (2) spread of antibiotic-resistant clones and (3) further remodelling of PBP genes by mutations and further gene exchange. Although the risk factors associated with carriage and infection by resistant strains are well known, the effect of community-wide interventions is not. Prudent use of antibiotics, vaccination by improved conjugate vaccines and infection control measures are likely to be important in preserving the efficacy of avaliable antimicrobial agents.

Original languageEnglish
Pages (from-to)203-219
Number of pages17
JournalBailliere's Clinical Infectious Diseases
Issue number2
Publication statusPublished - 1999

Other keywords

  • Antibiotic resistance
  • Antibiotics
  • Antimicrobial chemotherapy
  • Streptococcus pneumoniae
  • Vaccination


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