Geographic diversity and temporal trends of antimicrobial resistance in Streptococcus pneumoniae in the United States
Geographic diversity and temporal trends of antimicrobial resistance in Streptococcus pneumoniae in the United States
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DOI：
10.1038/nm839
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发表时间：
2003-04-01
期刊：
影响因子：
82.9
通讯作者：
Lipsitch, M
中科院分区：
文献类型：
--
作者：
McCormick, AW;Whitney, CG;Lipsitch, M
在美国各地，肺炎链球菌对抗生素的耐药性正在增加，但不同地理区域之间存在很大差异。我们表明，地理变异模式最好通过抗性选择强度来解释，这反映在各个血清型内抗性比例之间的差异，而不是特定血清型频率之间的差异。使用数学传播模型，我们分析了单一和双重耐药微生物比例的时间趋势，发现对青霉素和红霉素均耐药的肺炎球菌菌株的增长速度快于对其中任何一种单一耐药的菌株。使用该模型，我们预测，到 2004 年 7 月 1 日，在没有疫苗的情况下，疾病控制和预防中心 (CDC) 活性细菌核心监测 (ABC) 站点中 41% 的肺炎球菌合计将具有双重耐药性，其中 5% 仅对青霉素耐药，5% 仅对红霉素耐药。
Resistance of Streptococcus pneumoniae to antibiotics is increasing throughout the United States, with substantial variation among geographic regions. We show that patterns of geographic variation are best explained by the intensity of selection for resistance, which is reflected by differences between the proportions of resistance within individual serotypes, rather than by differences between the frequencies of particular serotypes. Using a mathematical transmission model, we analyzed temporal trends in the proportions of singly and dually resistant organisms and found that pneumococcal strains resistant to both penicillin and erythromycin are increasing faster than strains singly resistant to either. Using the model, we predict that by 1 July 2004, in the absence of a vaccine, 41% of pneumococci at the Centers for Disease Control and Prevention (CDC)'s Active Bacterial Core surveillance (ABCs) sites, taken together, will be dually resistant, with 5% resistant to penicillin only and 5% to erythromycin only.