ArticlePloS one2012
The fitness cost of antibiotic resistance in Streptococcus pneumoniae: insight from the field.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Population-level mathematical modeling of antimicrobial resistance: a systematic review.BMC medicine · 2019Pooled it
- Temporal Trends in Phenotypic Macrolide and Nonmacrolide Resistance for Streptococcus pneumoniae Nasopharyngeal Samples Up to 36 Months after Mass Azithromycin Administration in a Cluster-Randomized Trial in Niger.The American journal of tropical medicine and hygiene · 2023Trial
- Gut Resistome of Preschool Children After Prolonged Mass Azithromycin Distribution: A Cluster-randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Trial
- Nasopharyngeal carriage and macrolide resistance in Indigenous children with bronchiectasis randomized to long-term azithromycin or placebo.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2015Trial
- Impact of intermittent preventive treatment in pregnancy with azithromycin-containing regimens on maternal nasopharyngeal carriage and antibiotic sensitivity of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus: a cross-sectional survey at delivery.Journal of clinical microbiology · 2015Trial
- Antimicrobial resistance within the one health lens: global drivers, mechanisms and public health policy gaps in low resource settings.Frontiers in cellular and infection microbiology · 2026Review
- Quantifying the effects of antibiotic resistance and within-host competition on strain fitness in Streptococcus pneumoniae.PLoS biology · 2025Article
- Longitudinal genomic analysis of Neisseria gonorrhoeae transmission dynamics in Australia.Nature communications · 2024Article
- Pneumococcal population dynamics: Investigating vaccine-induced changes through multiscale modelling.PLoS computational biology · 2023Article
- Article
- Pneumococcal within-host diversity during colonization, transmission and treatment.Nature microbiology · 2022Article
- Effect of spdC gene expression on virulence and antibiotic resistance in clinical Staphylococcus aureus isolates.International microbiology : the official journal of the Spanish Society for Microbiology · 2022Article
- Increasing prevalence of hypervirulent ST5 methicillin susceptibleEmerging microbes & infections · 2021Article
- The Surge of Hypervirulent ST398 MRSA Lineage With Higher Biofilm-Forming Ability Is a Critical Threat to Clinics.Frontiers in microbiology · 2021Article
- Biannual Treatment of Preschool Children with Single Dose Azithromycin to Reduce Mortality: Impact on Azithromycin Resistance in the MORDOR Trial in Tanzania.The American journal of tropical medicine and hygiene · 2020Article
- Mathematical modelling for antibiotic resistance control policy: do we know enough?BMC infectious diseases · 2019Article
- Impact of Antibiotic Resistance on Treatment of Pneumococcal Disease in Ethiopia: An Agent-Based Modeling Simulation.The American journal of tropical medicine and hygiene · 2019Article
- Models of Trachoma Transmission and Their Policy Implications: From Control to Elimination.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Review
- Vaccination can drive an increase in frequencies of antibiotic resistance among nonvaccine serotypes ofProceedings of the National Academy of Sciences of the United States of America · 2018Article
- Vibrio Pathogens: A Public Health Concern in Rural Water Resources in Sub-Saharan Africa.International journal of environmental research and public health · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundLaboratory studies have suggested that antibiotic resistance may result in decreased fitness in the bacteria that harbor it. Observational studies have supported this, but due to ethical and practical considerations, it is rare to have experimental control over antibiotic prescription rates. METHODS AND
findingsWe analyze data from a 54-month longitudinal trial that monitored pneumococcal drug resistance during and after biannual mass distribution of azithromycin for the elimination of the blinding eye disease, trachoma. Prescription of azithromycin and antibiotics that can create cross-resistance to it is rare in this part of the world. As a result, we were able to follow trends in resistance with minimal influence from unmeasured antibiotic use. Using these data, we fit a probabilistic disease transmission model that included two resistant strains, corresponding to the two dominant modes of resistance to macrolide antibiotics. We estimated the relative fitness of these two strains to be 0.86 (95% CI 0.80 to 0.90), and 0.88 (95% CI 0.82 to 0.93), relative to antibiotic-sensitive strains. We then used these estimates to predict that, within 5 years of the last antibiotic treatment, there would be a 95% chance of elimination of macrolide resistance by intra-species competition alone.
conclusionsAlthough it is quite possible that the fitness cost of macrolide resistance is sufficient to ensure its eventual elimination in the absence of antibiotic selection, this process takes time, and prevention is likely the best policy in the fight against resistance.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.