Longitudinal Nasopharyngeal Carriage and Antibiotic Resistance of Respiratory Bacteria in Indigenous Australian and Alaska Native Children with Bronchiectasis

Autor: Alisa Reasonover, Paul J. Torzillo, Lori Chikoyak, Gabrielle B. McCallum, Rosalyn J. Singleton, Greg Redding, Anne B. Chang, Mark D. Chatfield, Allen C. Cheng, Amanda J. Leach, Ngiare Brown, Patricia C. Valery, Malcolm McDonald, Kim M. Hare, Peter S. Morris, Keith Grimwood, Heidi C. Smith-Vaughan
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Bacterial Diseases
Male
Pulmonology
lcsh:Medicine
medicine.disease_cause
Azithromycin
Pediatrics
Haemophilus influenzae
Moraxella catarrhalis
0302 clinical medicine
Nasopharynx
030212 general & internal medicine
Longitudinal Studies
Staphylococcus Aureus
lcsh:Science
Child
Haemophilus Influenzae
0303 health sciences
Multidisciplinary
biology
medicine.diagnostic_test
Drug Resistance
Microbial
Pneumococcus
3. Good health
Bronchiectasis
Infectious Diseases
Streptococcus pneumoniae
Child
Preschool
Medicine
Female
medicine.drug
Research Article
medicine.medical_specialty
Clinical Research Design
Pediatric Pulmonology
Microbiology
Throat culture
03 medical and health sciences
Antibiotic resistance
Internal medicine
Drug Resistance
Bacterial
medicine
Humans
Biology
030306 microbiology
business.industry
lcsh:R
Australia
Infant
Newborn
Beta lactam antibiotic
Infant
Bacteriology
biology.organism_classification
Carriage
lcsh:Q
business
Alaska
Zdroj: PLoS ONE
PLoS ONE, Vol 8, Iss 8, p e70478 (2013)
ISSN: 1932-6203
Popis: BACKGROUND: Indigenous children in Australia and Alaska have very high rates of chronic suppurative lung disease (CSLD)/bronchiectasis. Antibiotics, including frequent or long-term azithromycin in Australia and short-term beta-lactam therapy in both countries, are often prescribed to treat these patients. In the Bronchiectasis Observational Study we examined over several years the nasopharyngeal carriage and antibiotic resistance of respiratory bacteria in these two PCV7-vaccinated populations. METHODS: Indigenous children aged 0.5-8.9 years with CSLD/bronchiectasis from remote Australia (n = 79) and Alaska (n = 41) were enrolled in a prospective cohort study during 2004-8. At scheduled study visits until 2010 antibiotic use in the preceding 2-weeks was recorded and nasopharyngeal swabs collected for culture and antimicrobial susceptibility testing. Analysis of respiratory bacterial carriage and antibiotic resistance was by baseline and final swabs, and total swabs by year. RESULTS: Streptococcus pneumoniae carriage changed little over time. In contrast, carriage of Haemophilus influenzae declined and Staphylococcus aureus increased (from 0% in 2005-6 to 23% in 2010 in Alaskan children); these changes were associated with increasing age. Moraxella catarrhalis carriage declined significantly in Australian, but not Alaskan, children (from 64% in 2004-6 to 11% in 2010). While beta-lactam antibiotic use was similar in the two cohorts, Australian children received more azithromycin. Macrolide resistance was significantly higher in Australian compared to Alaskan children, while H. influenzae beta-lactam resistance was higher in Alaskan children. Azithromycin use coincided significantly with reduced carriage of S. pneumoniae, H. influenzae and M. catarrhalis, but increased carriage of S. aureus and macrolide-resistant strains of S. pneumoniae and S. aureus (proportion of carriers and all swabs), in a 'cumulative dose-response' relationship. CONCLUSIONS: Over time, similar (possibly age-related) changes in nasopharyngeal bacterial carriage were observed in Australian and Alaskan children with CSLD/bronchiectasis. However, there were also significant frequency-dependent differences in carriage and antibiotic resistance that coincided with azithromycin use.
Databáze: OpenAIRE
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