title: Limited spread of penicillin-nonsusceptible pneumococci, Skåne County, Sweden.
abstract: In response to increasing frequencies of penicillin-nonsusceptible pneumococci (PNSP), for which the MIC of penicillin was >0.12 mg/L, in Skåne County, southern Sweden, national recommendations were initiated in 1995 to limit the spread of pneumococci with high MICs (> or =0.5 mg/L) of penicillin (PRP), especially among children of preschool age. Traditional communicable disease control measures were combined with actions against inappropriate antimicrobial drug use. During the first 6 years that these recommendations were applied in Skåne County, the average frequency of penicillin-resistant pneumococci has been stable at =2.6%, as has the average PNSP frequency (7.4%). However, PNSP have been unevenly distributed in the county, with the highest frequencies in the southwest. Simultaneously, the rate of antimicrobial drug use for children <6 years of age was reduced by 20%. Thus the spread of PNSP between and within the municipalities in the county has been limited.
authors.affiliation: Department of Clinical Microbiology, Lund University Hospital, Lund, Sweden. eva.z.melander@skane.se
authors.forename: Eva
authors.initials: E
authors.lastname: Melander
authors.forename: Hans-Bertil
authors.initials: HB
authors.lastname: Hansson
authors.forename: Sigvard
authors.initials: S
authors.lastname: Mölstad
authors.forename: Kristina
authors.initials: K
authors.lastname: Persson
authors.forename: Håkan
authors.initials: H
authors.lastname: Ringberg
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002353:Carrier State / Q000382:microbiology; D002675:Child, Preschool; D003140:Communicable Disease Control; D006801:Humans; D007223:Infant; D010403:Penicillin Resistance / Q000502:physiology*; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D015995:Prevalence; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000254:growth & development / Q000302:isolation & purification; D013548:Sweden / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents