title: Impact of socioeconomic factors and antibiotic prescribing on penicillin- non-susceptible Streptococcus pneumoniae in the city of Malmö.
abstract: Carriage or infection with penicillin-non-susceptible Streptococcus pneumoniae (PNSP) has been associated with antibiotic prescribing, socioeconomic factors, and attendance at day-care centres (DCCs). In the present study, linear regression was used to estimate the relation between these risk factors and the incidence of PNSP cases (non-susceptible defined as MIC =0.5 microg/ml for penicillin) in 19 residential areas in Malmö. The number of PNSP cases was associated with the number of preschool children in the area (r=0.950, p<0.0001). The incidence of PNSP cases per 1000 children was positively correlated with antibiotic prescribing (r=0.614, p<0.01) but not with DCC attendance or any of the socioeconomic factors studied. Antibiotic prescribing was, however, positively correlated with per capita income (r = 0.597, p<0.05). Thus, even if higher socioeconomic status alone had no apparent influence on the incidence of PNSP in Malmö, there was still an indirect relation between these 2 factors, since inhabitants in these areas consumed more antibiotics. Based on these results, the spread of antibiotic-resistant pneumococci seems to be most reliably restricted by pursuing a restrictive policy regarding antibiotic prescription.
authors: Department of Paediatrics, Malmö University Hospital, Lund University, Malmö, Sweden. percy.nilsson@pediatrik.mas.lu.se
authors: Percy
authors: P
authors: Nilsson
authors: Martin H
authors: MH
authors: Laurell
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002353:Carrier State / Q000453:epidemiology; D002656:Child Day Care Centers; D002675:Child, Preschool; D004363:Drug Utilization; D006801:Humans; D010403:Penicillin Resistance; D012307:Risk Factors; D012959:Socioeconomic Factors; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D013548:Sweden / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents