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Increased macrolide resistance in Streptococcus pneumoniae in Slovakia may be linked to increased macrolide
Peter Kunč1, Jaroslav Fábry1, Katarina Ištvánková1
1Clinic of Paediatric Respiratory Diseases and Tuberculosis, National Institute of Paediatric Tuberculosis and Respiratory Diseases, Dolny Smokovec, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
Objectives:
Given the widespread use of macrolide antibiotics and growing concerns over antimicrobial resistance, this study aimed to investigate recent trends in macrolide consumption in Slovakia and to determine the corresponding changes in Streptococcus pneumoniae resistance in a paediatric cohort.
Methods:
We conducted a retrospective analysis of 1,083 nasal swab cultures from children with recurrent respiratory infections and atopy, comparing two distinct 5-year periods: 2008-2012 and 2019-2023. Consumption data was based on the European Centre for Disease Prevention and Control reports.
Results:
National data confirmed that Slovakia has one of the highest consumption rates of macrolides, lincosamides, and streptogramins (ATC group J01F) in Europe. The comparative analysis of patient samples revealed a statistically significant 11% increase in erythromycin-resistant S. pneumoniae (p < 0.001) and a 5% increase in clindamycin-resistant strains (p < 0.001) between the two study periods.
Conclusions:
The concurrent rise in macrolide consumption and S. pneumoniae resistance in Slovakia highlights a significant public health threat. These findings underscore the urgent need for robust antibiotic stewardship programmes and the promotion of rational prescribing practices to preserve the efficacy of macrolides.
Insights
Macrolide antibiotic use in Slovakia is high, mirroring increased resistance in pediatric Streptococcus pneumoniae strains. Urgent antibiotic stewardship is needed to combat this public health threat.
Area of Science:
- Medical Microbiology
- Public Health
- Pharmacology
Background:
- Macrolide antibiotics are widely used globally.
- Antimicrobial resistance is a growing public health concern.
- Slovakia exhibits high macrolide consumption rates in Europe.
Purpose of the Study:
- To analyze macrolide consumption trends in Slovakia.
- To assess changes in Streptococcus pneumoniae resistance in children.
- To correlate antibiotic use with resistance patterns.
Main Methods:
- Retrospective analysis of 1,083 nasal swab cultures from children.
- Comparison of two 5-year periods: 2008-2012 and 2019-2023.
- Utilized European Centre for Disease Prevention and Control data for consumption.
Main Results:
- Slovakia shows high consumption of macrolides, lincosamides, and streptogramins (ATC J01F).
- A significant 11% increase in erythromycin-resistant S. pneumoniae was observed (p < 0.001).
- A significant 5% increase in clindamycin-resistant S. pneumoniae strains was noted (p < 0.001).
Conclusions:
- Rising macrolide consumption correlates with increased S. pneumoniae resistance in Slovakia.
- This trend poses a significant public health threat.
- Urgent implementation of antibiotic stewardship and rational prescribing is essential to maintain macrolide efficacy.
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