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Clonal spread of resistant pneumococci despite diminished antimicrobial use
Vilhjalmur A Arason1, Adalsteinn Gunnlaugsson, Johann A Sigurdsson
1Department of Family Medicine, University of Iceland, Solvangur, Hafnarfjordur.
Microbial Drug Resistance (Larchmont, N.Y.)
|October 5, 2002
Summary
Reducing antimicrobial use can lower resistance rates, but pandemic clones may still spread. Community interventions impact penicillin-nonsusceptible pneumococci (PNSP) spread, influenced by clonal spread and herd immunity.
Area of Science:
- Microbiology
- Epidemiology
- Public Health
Background:
- Community-wide interventions to reduce antimicrobial resistance rates are not well understood.
- Penicillin-nonsusceptible pneumococci (PNSP) represent a growing public health concern.
Purpose of the Study:
- To evaluate the impact of reduced antimicrobial usage on the spread of PNSP in four Icelandic communities.
- To compare current PNSP prevalence and antimicrobial use with data from five years prior.
Main Methods:
- A randomized sample of 953 children (1-6 years old) was selected from four communities.
- Nasopharyngeal carriage of PNSP and individual/community antimicrobial use were measured.
- Data were compared to an identical study conducted five years earlier.
Main Results:
- Pneumococci carriage was 51.7%, with 8.1% being PNSP (vs. 8.5% previously).
- Antimicrobial use decreased significantly in participants and the community.
- PNSP prevalence increased in remote areas despite reduced consumption.
Conclusions:
- Interventions effectively reduced antimicrobial use.
- Pandemic multiresistant clones can spread rapidly in low-antimicrobial-use communities.
- Clonal spread and herd immunity are critical factors in intervention effectiveness.