title: Macrolide use identified as risk factor for macrolide-resistant Streptococcus pneumoniae in a 17-center case-control study.
abstract: The objective of the case-control study presented here was to examine the risk factors for macrolide-resistant Streptococcus pneumoniae. As part of a 44-center U.S. surveillance study, 1,817 unique isolates of S. pneumoniae were collected from November 2002 through April 2003. Seventy-five randomly selected macrolide-resistant isolates (cases) were each matched with one susceptible control. Macrolide use in the 6 weeks prior to sample collection was reported for seven cases and one control. The final conditional logistic regression model identified two statistically significant variables: a history of alcohol abuse was protective, while macrolide use in the 6 weeks prior to sample collection was a significant risk factor for macrolide-resistant S. pneumoniae. Macrolide resistance was associated with use of any antibiotic during the prior 6 weeks, and was most strongly associated with previous macrolide use.
authors.affiliation: Division of Medical Microbiology, Department of Pathology 265 MRC, University of Iowa, Iowa, IA, 52242, USA. susan-beekmann@uiowa.edu
authors.forename: S E
authors.initials: SE
authors.lastname: Beekmann
authors.forename: D J
authors.initials: DJ
authors.lastname: Diekema
authors.forename: K P
authors.initials: KP
authors.lastname: Heilmann
authors.forename: S S
authors.initials: SS
authors.lastname: Richter
authors.forename: G V
authors.initials: GV
authors.lastname: Doern
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D004917:Erythromycin / Q000494:pharmacology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018942:Macrolides / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides; D004917:Erythromycin