The role of antimicrobial use in the epidemiology of resistant pneumococci: A 10-year follow up

2.50
Hdl Handle:
http://hdl.handle.net/2336/10596
Title:
The role of antimicrobial use in the epidemiology of resistant pneumococci: A 10-year follow up
Authors:
Arason, Vilhjalmur A; Sigurdsson, Johann A; Erlendsdottir, Helga; Gudmundsson, Sigurdur; Kristinsson, Karl G
Citation:
Microb. Drug Resist. 2006, 12(3):169-76
Issue Date:
1-Sep-2006
Abstract:
The relative effects of risk factors on the prevalence of resistant pneumococcal clones are hard to determine. Our aim was to evaluate the effect of risk factors on the prevalence of resistant pneumococci in Iceland in 2003 and compare these data with results of identical studies performed in 1993 and 1998. A randomized sample of 1,107 children was chosen from all 2,532 children 1 to 6 years old living in four communities. Pneumococci were carried by 64% of the 824 children enrolled and 9.5% were penicillin nonsusceptible (PNSP), as opposed to 8.1% (1998) and 8.5% (1993), and multiresistant strains of serotype 6B were 2.5% compared to 7.5% and 7.7% (p < 0.001). Antimicrobial use had declined in 10 years from 1.5 to 1.0 courses/child per year. The only significant risk factor for carriage of PNSP and erythromycin-resistant pneumococci was antimicrobial consumption. The multiresistant type 6B strains disappeared from the areas with the lowest antimicrobial use but maintained unchanged prevalence in the area with the highest use. The number of erythromycin- resistant, penicillin-susceptible strains of all pneumococci (37/475, 7.8%) increased significantly from the previous studies (7/353, 2.0%, 1998, and 2/390, 0.5%, 1993). This observation is associated with increased use of macrolides, especially azithromycin, in one of the study areas. Spread of novel resistant clones appears to be the main reason for rapid and significant changes in pneumococcal resistance rates. The choice of antimicrobial class appears to influence the selective environment favoring particular resistant clones.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://www.liebertonline.com/doi/abs/10.1089/mdr.2006.12.169

Full metadata record

DC FieldValue Language
dc.contributor.authorArason, Vilhjalmur A-
dc.contributor.authorSigurdsson, Johann A-
dc.contributor.authorErlendsdottir, Helga-
dc.contributor.authorGudmundsson, Sigurdur-
dc.contributor.authorKristinsson, Karl G-
dc.date.accessioned2007-03-12T13:34:11Z-
dc.date.available2007-03-12T13:34:11Z-
dc.date.issued2006-09-01-
dc.date.submitted2007-03-12-
dc.identifier.citationMicrob. Drug Resist. 2006, 12(3):169-76en
dc.identifier.issn1076-6294-
dc.identifier.pmid17002543-
dc.identifier.doi10.1089/mdr.2006.12.169-
dc.identifier.otherBAC12-
dc.identifier.urihttp://hdl.handle.net/2336/10596-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractThe relative effects of risk factors on the prevalence of resistant pneumococcal clones are hard to determine. Our aim was to evaluate the effect of risk factors on the prevalence of resistant pneumococci in Iceland in 2003 and compare these data with results of identical studies performed in 1993 and 1998. A randomized sample of 1,107 children was chosen from all 2,532 children 1 to 6 years old living in four communities. Pneumococci were carried by 64% of the 824 children enrolled and 9.5% were penicillin nonsusceptible (PNSP), as opposed to 8.1% (1998) and 8.5% (1993), and multiresistant strains of serotype 6B were 2.5% compared to 7.5% and 7.7% (p < 0.001). Antimicrobial use had declined in 10 years from 1.5 to 1.0 courses/child per year. The only significant risk factor for carriage of PNSP and erythromycin-resistant pneumococci was antimicrobial consumption. The multiresistant type 6B strains disappeared from the areas with the lowest antimicrobial use but maintained unchanged prevalence in the area with the highest use. The number of erythromycin- resistant, penicillin-susceptible strains of all pneumococci (37/475, 7.8%) increased significantly from the previous studies (7/353, 2.0%, 1998, and 2/390, 0.5%, 1993). This observation is associated with increased use of macrolides, especially azithromycin, in one of the study areas. Spread of novel resistant clones appears to be the main reason for rapid and significant changes in pneumococcal resistance rates. The choice of antimicrobial class appears to influence the selective environment favoring particular resistant clones.en
dc.language.isoenen
dc.publisherMary Ann Lieberten
dc.relation.urlhttp://www.liebertonline.com/doi/abs/10.1089/mdr.2006.12.169en
dc.subject.meshAnti-Bacterial Agentsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshDrug Resistance, Bacterialen
dc.subject.meshErythromycinen
dc.subject.meshFemaleen
dc.subject.meshFollow-Up Studiesen
dc.subject.meshIceland/epidemiologyen
dc.subject.meshInfanten
dc.subject.meshMaleen
dc.subject.meshNasopharynxen
dc.subject.meshPenicillin Resistanceen
dc.subject.meshPenicillinsen
dc.subject.meshPneumococcal Infectionsen
dc.subject.meshRisk Factorsen
dc.subject.meshStreptococcus pneumoniaeen
dc.titleThe role of antimicrobial use in the epidemiology of resistant pneumococci: A 10-year follow upen
dc.typeArticleen
dc.identifier.journalMicrobial drug resistanceen
dc.format.digYES-

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