2.50
Hdl Handle:
http://hdl.handle.net/2336/31314
Title:
Clonal spread of resistant pneumococci despite diminished antimicrobial use
Authors:
Arason, Vilhjalmur A; Gunnlaugsson, Adalsteinn; Sigurdsson, Johann A; Erlendsdottir, Helga; Gudmundsson, Sigurdur; Kristinsson, Karl G
Citation:
Microb. Drug Resist. 2002, 8(3):187-92
Issue Date:
1-Sep-2002
Abstract:
The effects of community-wide interventions to reduce resistance rates are poorly understood. This study evaluated the effect of reduced antimicrobial usage on the spread of penicillin-nonsusceptible pneumococci (PNSP) in four communities in Iceland. The study was performed after interventions to reduce antimicrobial usage and compared to an identical study performed 5 years before. A randomized sample of 953 children was chosen from all 2,900 1- to 6-year-old children living in four well-defined communities. The main outcome measures were nasopharyngeal carriage of PNSP and individual and community use of antimicrobials. Pneumococci were carried by 51.7% of the 743 children enrolled, and 8.1% of the pneumococci were PNSP as opposed to 8.5% in the previous study. The antimicrobial use of participants had been reduced from 1.5 to 1.1 courses/year and the overall use among children <7 years old living in the study areas from 13.6 to 11.1 defined daily dosages/1000 children per day. The prevalence of PNSP increased in the two areas furthest away from the capital area despite reduced consumption. The major risk factors for carriage of PNSP remained the same. Interventions can be effective in reducing antimicrobial use. Pandemic multiresistant clones can also spread fast in small communities with low antimicrobial use, where their appearance may be delayed compared to highly populated urban areas. Clonal spread and herd immunity are important factors to be considered in the evaluation of intervention effects.
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/10.1089/107662902760326896

Full metadata record

DC FieldValue Language
dc.contributor.authorArason, Vilhjalmur A-
dc.contributor.authorGunnlaugsson, Adalsteinn-
dc.contributor.authorSigurdsson, Johann A-
dc.contributor.authorErlendsdottir, Helga-
dc.contributor.authorGudmundsson, Sigurdur-
dc.contributor.authorKristinsson, Karl G-
dc.date.accessioned2008-07-08T14:00:26Z-
dc.date.available2008-07-08T14:00:26Z-
dc.date.issued2002-09-01-
dc.date.submitted2008-07-06-
dc.identifier.citationMicrob. Drug Resist. 2002, 8(3):187-92en
dc.identifier.issn1076-6294-
dc.identifier.pmid12363007-
dc.identifier.doi10.1089/107662902760326896-
dc.identifier.urihttp://hdl.handle.net/2336/31314-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractThe effects of community-wide interventions to reduce resistance rates are poorly understood. This study evaluated the effect of reduced antimicrobial usage on the spread of penicillin-nonsusceptible pneumococci (PNSP) in four communities in Iceland. The study was performed after interventions to reduce antimicrobial usage and compared to an identical study performed 5 years before. A randomized sample of 953 children was chosen from all 2,900 1- to 6-year-old children living in four well-defined communities. The main outcome measures were nasopharyngeal carriage of PNSP and individual and community use of antimicrobials. Pneumococci were carried by 51.7% of the 743 children enrolled, and 8.1% of the pneumococci were PNSP as opposed to 8.5% in the previous study. The antimicrobial use of participants had been reduced from 1.5 to 1.1 courses/year and the overall use among children <7 years old living in the study areas from 13.6 to 11.1 defined daily dosages/1000 children per day. The prevalence of PNSP increased in the two areas furthest away from the capital area despite reduced consumption. The major risk factors for carriage of PNSP remained the same. Interventions can be effective in reducing antimicrobial use. Pandemic multiresistant clones can also spread fast in small communities with low antimicrobial use, where their appearance may be delayed compared to highly populated urban areas. Clonal spread and herd immunity are important factors to be considered in the evaluation of intervention effects.en
dc.language.isoenen
dc.publisherMary Ann Lieberten
dc.relation.urlhttp://www.liebertonline.com/doi/abs/10.1089/107662902760326896en
dc.subject.meshAnti-Bacterial Agentsen
dc.subject.meshChilden
dc.subject.meshHumansen
dc.subject.meshIcelanden
dc.subject.meshNoseen
dc.subject.meshPenicillin Resistanceen
dc.subject.meshPharynxen
dc.subject.meshStreptococcus pneumoniaeen
dc.titleClonal spread of resistant pneumococci despite diminished antimicrobial useen
dc.typeArticleen
dc.contributor.departmentDepartment of Family Medicine, University of Iceland, Solvangur, Hafnarfjordur.en
dc.identifier.journalMicrobial drug resistance (Larchmont, N.Y.)en

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