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Macrolide use identified as risk factor for macrolide-resistant Streptococcus pneumoniae in a 17-center case-control study

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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.

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Acknowledgements

The authors are grateful to the following individuals for providing the data for the isolates of S. pneumoniae used in this case-control study: A. Limaye (Seattle, Washington), M.L. Wilson (Denver, Colorado), G. Hall (Cleveland, Ohio), S. Kehl (Milwaukee, Wisconsin), E. Burd (Detroit, Michigan), G. Denys (Indianapolis, Indiana), P. Klein (St. Louis, Missouri), R. Thomson Jr. (Evanston, Illinois), J.D. Schwartzman (Lebanon, New Hampshire), P. Pancholi (New York, New York), P. Bourbeau (Danville, Pennsylvania), J.E. Carter (Mobile, Alabama), J. Snyder (Louisville, Kentucky), K. Fiebelkorn (San Antonio, Texas), R. Horvath (Kansas City, Kansas), and D.C. Halstead (Jacksonville, Florida).

The authors are also grateful to Miriam (Bridget) Zimmerman, Ph.D., who provided invaluable statistical advice and assistance.

All data and experiments comply with the current laws of the USA.

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Authors and Affiliations

  1. Division of Medical Microbiology, Department of Pathology 265 MRC, University of Iowa, Iowa, IA, 52242, USA

    S. E. Beekmann, D. J. Diekema, K. P. Heilmann, S. S. Richter & G. V. Doern

  2. Division of Infectious Diseases, Department of Internal Medicine, Roy J. and Lucille A. Carver University of Iowa College of Medicine, Iowa City, IA, USA

    D. J. Diekema

Authors
  1. S. E. Beekmann
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  2. D. J. Diekema
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  3. K. P. Heilmann
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  4. S. S. Richter
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  5. G. V. Doern
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Corresponding author

Correspondence to S. E. Beekmann.

Additional information

The results of this study were presented at the 45th ICAAC Meeting in December 2005.

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Beekmann, S.E., Diekema, D.J., Heilmann, K.P. et al. Macrolide use identified as risk factor for macrolide-resistant Streptococcus pneumoniae in a 17-center case-control study. Eur J Clin Microbiol Infect Dis 25, 335–339 (2006). https://doi.org/10.1007/s10096-006-0137-8

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  • DOI: https://doi.org/10.1007/s10096-006-0137-8

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