ArticleAntimicrobial agents and chemotherapy2007
Risk factors for development of multiple-class resistance to Streptococcus pneumoniae Strains in Belgium over a 10-year period: antimicrobial consumption, population density, and geographic location.
Article in Antimicrobial agents and chemotherapy, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Antibiotic selection pressure and macrolide resistance in nasopharyngeal Streptococcus pneumoniae: a cluster-randomized clinical trial.PLoS medicine · 2010Trial
- Whole-Genome Analysis-Based Phylogeographic Investigation of Streptococcus pneumoniae Serotype 19A Sequence Type 320 Isolates in Japan.Antimicrobial agents and chemotherapy · 2022Article
- Vaccination of mice with hybrid protein containing Exotoxin S and PcrV with adjuvants alum and MPL protects Pseudomonas aeruginosa infections.Scientific reports · 2022Article
- Risk factors for carriage of Streptococcus pneumoniae in children.BMC pediatrics · 2018Article
- Biological and Epidemiological Features of Antibiotic-Resistant Streptococcus pneumoniae in Pre- and Post-Conjugate Vaccine Eras: a United States Perspective.Clinical microbiology reviews · 2016Review
- Outpatient Antibiotic Prescription.Deutsches Arzteblatt international · 2016Article
- Risk factors for multidrug-resistant invasive pneumococcal disease in South Africa, a setting with high HIV prevalence, in the prevaccine era from 2003 to 2008.Antimicrobial agents and chemotherapy · 2012Article
- Preventing urinary tract infection: progress toward an effective Escherichia coli vaccine.Expert review of vaccines · 2012Review
- Evaluation of the Do Bugs Need Drugs? program in British Columbia: Can we curb antibiotic prescribing?The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2011Article
- Macrolide susceptibility and serotype specific macrolide resistance of invasive isolates of Streptococcus pneumoniae in Germany from 1992 to 2008.BMC microbiology · 2010Article
- Improving quinolone use in hospitals by using a bundle of interventions in an interrupted time series analysis.Antimicrobial agents and chemotherapy · 2010Article
- Correlation between antibiotic use and resistance in a hospital: temporary and ward-specific observations.Infection · 2009Article
- Antibiotic use and population ecology: how you can reduce your "resistance footprint".CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2009Review
- Temporal and spatial distribution of clonal complexes of Streptococcus pneumoniae isolates resistant to multiple classes of antibiotics in Belgium, 1997 to 2004.Antimicrobial agents and chemotherapy · 2008Article
- Impact of the revised penicillin susceptibility breakpoints for Streptococcus pneumoniae on antimicrobial resistance rates of meningeal and non-meningeal pneumococcal strains.Annals of Saudi medicineArticle
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We investigated the impact of the usage of antibiotics in ambulatory patients in Belgium in 147 defined geographical circumscriptions and at the individual isolate level. The study included 14,448 Streptococcus pneumoniae strains collected by the Belgium national reference lab from 1994 to 2004. Additional risk factors for resistance, such as population density/structure and day care attendance, were investigated for the same time-space window. A statistical model that included resistance to two or more antimicrobial classes offered the best fit for measuring the changes in nonsusceptibility to penicillin, macrolides, and tetracycline over time and place in Belgium. Analysis at the geographic level identified antimicrobial consumption with a 1-year lag (0.5% increase per additional defined daily dose) and population density as independent predictors of multiple resistance. Independent risk factors at the isolate level were age (odds ratio [OR], 1.55 for children aged <5 years), population density (7% increase in multiple resistance per 100 inhabitants/km(2)), conjugate 7-valent vaccine serotype (OR, 14.3), location (OR, 1.55 for regions bordering high-resistance France), and isolate source (OR, 1.54 for ear isolates). The expansion of multiple-resistant strains explains most of the overall twofold increase and subsequent decrease in single antimicrobial resistance between 1994 and 2004. We conclude that factors in addition to antibiotic use, such as high population density and proximity to high-resistance regions, favor multiple resistance. Regional resistance rates are not linearly related to actual antibiotic use but are linked to past antibiotic use plus a combination of demographic and geographic factors.
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