{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:09:53Z","timestamp":1790554193734,"version":"4.1.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T00:00:00Z","timestamp":1541030400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2018,11]]},"abstract":"\n Background:<\/jats:title>\n \n Fluoroquinolones are antibiotics commonly used in the treatment of infections caused by\n Streptococcus pneumoniae<\/jats:italic>\n . However, rates of fluoroquinolone resistance are increasing with their frequent use. We designed this study to verify current fluoroquinolone resistance rates and risk factors for community-onset pneumococcal pneumonia.\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n A retrospective case\u2013control study was conducted in a tertiary referral hospital. The study population comprised patients admitted for pneumococcal pneumonia between January 2011 and May 2017. The case group included community-onset pneumonia caused by levofloxacin-nonsusceptible\n S. pneumoniae<\/jats:italic>\n . The control group consisted of two patients with levofloxacin-susceptible\n S. pneumoniae<\/jats:italic>\n who were admitted around the same time as each case.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 198 pneumococcal pneumonia cases were identified during the study period. Twenty-five levofloxacin-resistant\n S. pneumoniae<\/jats:italic>\n cases and 3 levofloxacin-intermediate\n S. pneumoniae<\/jats:italic>\n cases were included in the case group (nonsusceptibility rate\u2009=\u200914.1%). Multivariate analysis showed that healthcare-associated factors (odds ratio [OR] 4.78, 95% confidence interval [CI] 1.39\u201316.43,\n p<\/jats:italic>\n \u2009=\u20090.013), bronchopulmonary disease (OR 3.79, 95% CI 1.07\u201313.40,\n p<\/jats:italic>\n \u2009=\u20090.039), cerebrovascular disease (OR 6.08, 95% CI 1.24\u201329.75,\n p<\/jats:italic>\n \u2009=\u20090.026), and exposure to fluoroquinolones within the previous 3 months (OR 5.89, 95% CI 1.21\u201328.68,\n p<\/jats:italic>\n \u2009=\u20090.028) were associated with nonsusceptibility to levofloxacin.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Independent risk factors for levofloxacin-nonsusceptible pneumococcal pneumonia were recent hospitalization, bronchopulmonary disease, cerebrovascular disease, and prior antibiotic use within 3 months. Careful selection of empirical antibiotics is thus needed in at-risk patients. Similarly, efforts to prevent the interpersonal spread of drug-resistant pathogens in long-term care facilities and to restrict unnecessary fluoroquinolone prescriptions are important.<\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/mdr.2017.0416","type":"journal-article","created":{"date-parts":[[2018,3,22]],"date-time":"2018-03-22T11:38:09Z","timestamp":1521718689000},"page":"1412-1416","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Risk Factors for Community-Onset Pneumonia Caused by Levofloxacin-Nonsusceptible\n Streptococcus pneumoniae<\/i>"],"prefix":"10.1177","volume":"24","author":[{"given":"Hyeri","family":"Seok","sequence":"first","affiliation":[{"name":"Sungkyunkwan University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheol-In","family":"Kang","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungmin","family":"Huh","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Young","family":"Cho","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Eun","family":"Ha","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doo Ryeon","family":"Chung","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyong Ran","family":"Peck","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,11,12]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/S0140-6736(09)61204-6","article-title":"Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates","volume":"374","author":"O'Brien K.L.","year":"2009","unstructured":"O'Brien K.L., , Wolfson L.J., , Watt J.P., , Henkle E., , Deloria-Knoll M., , McCall N., , Lee E., , Mulholland K., , Levine O.S., , and Cherian T.. 2009. Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates. Lancet (London, England)., 374:893\u2013902.","journal-title":"Lancet (London, England)."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-012-1778-4"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02013089"},{"key":"e_1_3_2_5_2","first-page":"198","article-title":"Penicillin-resistant trend of Streptococcus pneumoniae in Asia: a systematic review","volume":"6","author":"Mamishi S.","year":"2014","unstructured":"Mamishi S., , Moradkhani S., , Mahmoudi S., , Hosseinpour-Sadeghi R., , and Pourakbari B.. 2014. Penicillin-resistant trend of Streptococcus pneumoniae in Asia: a systematic review. Iran J. Microbiol., 6:198\u2013210.","journal-title":"Iran J. 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