Mass administration of azithromycin and Streptococcus pneumoniae carriage: cross-Sectional surveys in the Gambia
Mass administration of azithromycin and Streptococcus pneumoniae carriage: cross-Sectional surveys in the Gambia
复制标题
DOI：
10.2471/blt.13.133462
复制
发表时间：
2014-07-01
影响因子：
11.1
通讯作者：
Roca, Anna
中科院分区：
文献类型：
--
作者：
Burr, Sarah E.;Milne, Sally;Roca, Anna
目的评估反复大规模药物管理（MDA）的阿奇霉素在冈比亚的鼻咽部携带肺炎链球菌和对抗生素耐药strains.Methods的出现，这项研究涉及的村庄，参加了一个集群随机试验比较的效果，一个与三个阿奇霉素MDA轮沙眼的患病率。仅包括大多数儿童接种了7价肺炎球菌结合疫苗的村庄。三个横断面调查进行了两个村庄，每年收到三个MDA轮：第一次之前的第三轮MDA轮和第二次和第三次，1和6个月，分别在第三轮MDA轮。第三次调查还包括30个月前接受过一轮农村发展评估的6个村庄。使用鼻咽拭子和阿奇霉素耐药性进行了评估，检测使用Etest.Findings-肺炎球菌I携带的患病率从43.4%下降到19.2%之间的第一次和第二次调查（P < 0.001），但反弹的第三次调查（45.8%; P = 0.591）。在第一次调查中成为携带者是第二次调查中成为携带者的危险因素（比值比：3.71; P < 0.001）。在第三次调查中，一轮和三轮MDA治疗后的携带率相似（分别为50.3%和45.8%; P = 0.170），阿奇霉素耐药率也相似（分别为0.3%和0.9%; P = 0.340）。pneumoniae菌株进行比较。
Objective To evaluate the effect of repeated mass drug administration (MDA) of azithromycin in the Gambia on the nasopharyngeal carriage of Streptococcus pneumoniae and on the emergence of antibiotic-resistant strains.Methods This study involved villages that participated in a cluster randomized trial comparing the effect of one versus three azithromycin MDA rounds on the prevalence of trachoma. Only villages in which most children received 7-valent pneumococcal conjugate vaccine were included. Three cross-sectional surveys were performed in two villages that received three annual MDA rounds: the first immediately before the third MDA round and the second and third, 1 and 6 months, respectively, after the third MDA round. The third survey also covered six villages that had received one MDA round 30 months previously. Pneumococcal carriage was assessed using nasopharyngeal swabs and azithromycin resistance was detected using the Etest.Findings The prevalence of pneumococca I carriage decreased from 43.4% to 19.2% between the first and second surveys (P < 0.001) but rebounded by the third survey (45.8%; P = 0.591). Being a carrier at the first survey was a risk factor for being a carrier at the second (odds ratio: 3.71; P < 0.001). At the third survey, the. prevalence of carriage was similar after one and three MDA rounds (50.3% versus 45.8%, respectively; P = 0.170), as was the prevalence of azithromycin resistance (0.3% versus 0.9%, respectively; P = 0.340).Conclusion Three azithromycin MDA rounds did not increase the prevalence of nasopharyngeal carriage of azithromycin-resistant S. pneumoniae strains compared with one round.