Long-term Impact of Oral Azithromycin Taken by Gambian Women During Labor on Prevalence and Antibiotic Susceptibility of Streptococcus pneumoniae and Staphylococcus aureus in Their Infants: Follow-up of a Randomized Clinical Trial.
Long-term Impact of Oral Azithromycin Taken by Gambian Women During Labor on Prevalence and Antibiotic Susceptibility of Streptococcus pneumoniae and Staphylococcus aureus in Their Infants: Follow-up of a Randomized Clinical Trial.
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DOI：
10.1093/cid/ciy254
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发表时间：
2018-09-28
期刊：
影响因子：
--
通讯作者：
Roca A
中科院分区：
文献类型：
--
作者：
Bojang A;Camara B;Jagne Cox I;Oluwalana C;Lette K;Usuf E;Bottomley C;Howden BP;D'Alessandro U;Roca A
分娩期间口服阿奇霉素（2克）会增加孕产妇和新生儿携带阿奇霉素耐药金黄色葡萄球菌的患病率。十二个月后，阿奇霉素耐药性恢复到基线值。两组儿童的肺炎链球菌对阿奇霉素的耐药性也相似。产妇口服阿奇霉素可减少孕产妇和新生儿的细菌携带，但在干预后至少 4 周内会增加阿奇霉素耐药细菌。我们评估了研究婴儿治疗后 12 个月的细菌携带率和阿奇霉素耐药率。 2014 年 11 月至 2015 年 5 月期间，从母亲在分娩期间接受阿奇霉素或安慰剂治疗的 11-13 个月大的儿童中采集了鼻咽拭子 (NPS)。使用常规微生物学方法分离肺炎链球菌和金黄色葡萄球菌。通过纸片扩散测定抗生素敏感性，并通过 Etest 或 VITEK-2 确认。 NPS 是从 461 名儿童身上收集的。阿奇霉素组和安慰剂组儿童中肺炎链球菌和金黄色葡萄球菌的患病率相似（85.0% vs 82.1%；比值比 [OR]，1.23 [95% 置信区间 {CI}，0.73–2.08]，肺炎链球菌为 21.7% vs 21.3%；OR，1.02 [95% CI， .64–1.64]金黄色葡萄球菌）。两组中阿奇霉素耐药肺炎链球菌的患病率相似（阿奇霉素组和安慰剂组的儿童分别为 1.8% 和 0.9%；OR，2.10 [95% CI，0.30–23.38]）； resistance to other antibiotics was also similar between arms.对于金黄色葡萄球菌，阿奇霉素组 (3.1%) 和安慰剂组 (2.6%) 儿童之间的阿奇霉素耐药性没有差异（OR，1.22 [95% CI，0.35–4.47]）或对任何其他抗生素的耐药性。在分娩期间接受治疗的妇女及其治疗后 4 周的婴儿中观察到金黄色葡萄球菌阿奇霉素耐药性较高的患病率在分娩后 12 个月时有所减弱。阿奇霉素干预不会诱导对肺炎链球菌或金黄色葡萄球菌的其他抗生素耐药性。 NCT01800942。
Giving oral azithromycin during labor (2 g) increased prevalence of maternal and neonatal carriage of azithromycin-resistant Staphylococcus aureus. Twelve months later, azithromycin resistance had returned to baseline values. Azithromycin resistance in Streptococcus pneumoniae was also similar between children from both arms. Oral azithromycin given to women in labor decreases maternal and neonatal bacterial carriage but increases azithromycin-resistant bacteria during at least 4 weeks following the intervention. We assessed the prevalence of bacterial carriage and azithromycin resistance 12 months after treatment among study infants. Nasopharyngeal swabs (NPSs) were collected between November 2014 and May 2015 from children aged 11–13 months whose mothers had received azithromycin or placebo during labor. Streptococcus pneumoniae and Staphylococcus aureus were isolated using conventional microbiological methods. Antibiotic susceptibility was determined by disk diffusion and confirmed by Etest or VITEK-2. NPSs were collected from 461 children. The prevalence of S. pneumoniae and S. aureus was similar between children from the azithromycin and placebo arms (85.0% vs 82.1%; odds ratio [OR], 1.23 [95% confidence interval {CI}, .73–2.08] for S. pneumoniae and 21.7% vs 21.3%; OR, 1.02 [95% CI, .64–1.64] for S. aureus). Prevalence of azithromycin-resistant S. pneumoniae was similar in both arms (1.8% vs 0.9% in children from the azithromycin and placebo arms, respectively; OR, 2.10 [95% CI, .30–23.38]); resistance to other antibiotics was also similar between arms. For S. aureus, there was no difference in azithromycin resistance between children in the azithromycin (3.1%) and placebo (2.6%) arms (OR, 1.22 [95% CI, .35–4.47]) or resistance to any other antibiotics. The higher prevalence of S. aureus azithromycin resistance observed among women treated during labor and their babies 4 weeks after treatment had waned 12 months after delivery. Azithromycin intervention did not induce other antibiotic resistance to S. pneumoniae or S. aureus. NCT01800942.
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影响因子：
8
作者：
Oluwalana, Claire;Camara, Bully;Roca, Anna
通讯作者：
Roca, Anna
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120.7
作者：
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影响因子：
11.1
作者：
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通讯作者：
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