Association Between Social Vulnerability and Streptococcus pneumoniae Antimicrobial Resistance in US Adults.

Autor:	Mohanty S; Merck Research Laboratories, Merck & Co., Inc., Rahway, New Jersey, USA., Ye G; Data Science and Analytics, Becton, Dickinson & Company, Franklin Lakes, New Jersey, USA., Sheets C; Data Science and Analytics, Becton, Dickinson & Company, Franklin Lakes, New Jersey, USA., Cossrow N; Merck Research Laboratories, Merck & Co., Inc., Rahway, New Jersey, USA., Yu KC; Medical Affairs, Becton, Dickinson & Company, Franklin Lakes, New Jersey, USA., White M; Merck Research Laboratories, Merck & Co., Inc., Rahway, New Jersey, USA., Klinker KP; Merck Research Laboratories, Merck & Co., Inc., Rahway, New Jersey, USA., Gupta V; Medical Affairs, Blue Health Intelligence, Chicago, IL 60601, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2024 Aug 16; Vol. 79 (2), pp. 305-311.
DOI:	10.1093/cid/ciae138
Abstrakt:	Background: Growing evidence indicates antimicrobial resistance disproportionately affects individuals living in socially vulnerable areas. This study evaluated the association between the CDC/ATSDR Social Vulnerability Index (SVI) and Streptococcus pneumoniae (SP) antimicrobial resistance (AMR) in the United States. Methods: Adult patients ≥18 years with 30-day nonduplicate SP isolates from ambulatory/hospital settings from January 2011 to December 2022 with zip codes of residence were evaluated across 177 facilities in the BD Insights Research Database. Isolates were identified as SP AMR if they were non-susceptible to ≥1 antibiotic class (macrolide, tetracycline, extended-spectrum cephalosporins, or penicillin). Associations between SP AMR and SVI score (overall and themes) were evaluated using generalized estimating equations with repeated measurements within county to account for within-cluster correlations. Results: Of 8008 unique SP isolates from 574 US counties across 39 states, the overall proportion of AMR was 49.9%. A significant association between socioeconomic status (SES) theme and SP AMR was detected with higher SES theme SVI score (indicating greater social vulnerability) associated with greater risk of AMR. On average, a decile increase of SES, indicating greater vulnerability, was associated with a 1.28% increased risk of AMR (95% confidence interval [CI], .61%, 1.95%; P = .0002). A decile increase of household characteristic score was associated with a 0.81% increased risk in SP AMR (95% CI, .13%, 1.49%; P = .0197). There was no association between racial/ethnic minority status, housing type and transportation theme, or overall SVI score and SP AMR. Conclusions: SES and household characteristics were the SVI themes most associated with SP AMR. Competing Interests: Potential conflicts of interest. S. M., N. C., M. W., and K. P. K. are employees of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, and may own stock/stock options in Merck & Co., Inc., Rahway, NJ, USA. C. S. and K. C. Y., are employees of Becton, Dickinson & Company, which was contracted by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, to conduct the study. G. Y. and V. G. were employees of Becton, Dickinson, & Company at the time of the study. K. C. Y. and V. G. own stock in Becton, Dickson & Company. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu