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Long-term Impact of Oral Azithromycin Taken by Gambian Women During Labor on Prevalence and Antibiotic Susceptibility of Streptococcus pneumoniae and Staphylococcus aureus in Their Infants: Follow-up of a Randomized Clinical Trial

BACKGROUND: Oral azithromycin given to women in labor decreases maternal and neonatal bacterial carriage but increases azithromycin-resistant bacteria during at least 4 weeks following the intervention. We assessed the prevalence of bacterial carriage and azithromycin resistance 12 months after trea...

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Autores principales: Bojang, Abdoulie, Camara, Bully, Jagne Cox, Isatou, Oluwalana, Claire, Lette, Kodou, Usuf, Effua, Bottomley, Christian, Howden, Benjamin P, D’Alessandro, Umberto, Roca, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160601/
https://www.ncbi.nlm.nih.gov/pubmed/29608659
http://dx.doi.org/10.1093/cid/ciy254
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author Bojang, Abdoulie
Camara, Bully
Jagne Cox, Isatou
Oluwalana, Claire
Lette, Kodou
Usuf, Effua
Bottomley, Christian
Howden, Benjamin P
D’Alessandro, Umberto
Roca, Anna
author_facet Bojang, Abdoulie
Camara, Bully
Jagne Cox, Isatou
Oluwalana, Claire
Lette, Kodou
Usuf, Effua
Bottomley, Christian
Howden, Benjamin P
D’Alessandro, Umberto
Roca, Anna
author_sort Bojang, Abdoulie
collection PubMed
description BACKGROUND: Oral azithromycin given to women in labor decreases maternal and neonatal bacterial carriage but increases azithromycin-resistant bacteria during at least 4 weeks following the intervention. We assessed the prevalence of bacterial carriage and azithromycin resistance 12 months after treatment among study infants. METHODS: Nasopharyngeal swabs (NPSs) were collected between November 2014 and May 2015 from children aged 11–13 months whose mothers had received azithromycin or placebo during labor. Streptococcus pneumoniae and Staphylococcus aureus were isolated using conventional microbiological methods. Antibiotic susceptibility was determined by disk diffusion and confirmed by Etest or VITEK-2. RESULTS: NPSs were collected from 461 children. The prevalence of S. pneumoniae and S. aureus was similar between children from the azithromycin and placebo arms (85.0% vs 82.1%; odds ratio [OR], 1.23 [95% confidence interval {CI}, .73–2.08] for S. pneumoniae and 21.7% vs 21.3%; OR, 1.02 [95% CI, .64–1.64] for S. aureus). Prevalence of azithromycin-resistant S. pneumoniae was similar in both arms (1.8% vs 0.9% in children from the azithromycin and placebo arms, respectively; OR, 2.10 [95% CI, .30–23.38]); resistance to other antibiotics was also similar between arms. For S. aureus, there was no difference in azithromycin resistance between children in the azithromycin (3.1%) and placebo (2.6%) arms (OR, 1.22 [95% CI, .35–4.47]) or resistance to any other antibiotics. CONCLUSIONS: The higher prevalence of S. aureus azithromycin resistance observed among women treated during labor and their babies 4 weeks after treatment had waned 12 months after delivery. Azithromycin intervention did not induce other antibiotic resistance to S. pneumoniae or S. aureus. CLINICAL TRIALS REGISTRATION: NCT01800942.
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spelling pubmed-61606012018-10-02 Long-term Impact of Oral Azithromycin Taken by Gambian Women During Labor on Prevalence and Antibiotic Susceptibility of Streptococcus pneumoniae and Staphylococcus aureus in Their Infants: Follow-up of a Randomized Clinical Trial Bojang, Abdoulie Camara, Bully Jagne Cox, Isatou Oluwalana, Claire Lette, Kodou Usuf, Effua Bottomley, Christian Howden, Benjamin P D’Alessandro, Umberto Roca, Anna Clin Infect Dis Articles and Commentaries BACKGROUND: Oral azithromycin given to women in labor decreases maternal and neonatal bacterial carriage but increases azithromycin-resistant bacteria during at least 4 weeks following the intervention. We assessed the prevalence of bacterial carriage and azithromycin resistance 12 months after treatment among study infants. METHODS: Nasopharyngeal swabs (NPSs) were collected between November 2014 and May 2015 from children aged 11–13 months whose mothers had received azithromycin or placebo during labor. Streptococcus pneumoniae and Staphylococcus aureus were isolated using conventional microbiological methods. Antibiotic susceptibility was determined by disk diffusion and confirmed by Etest or VITEK-2. RESULTS: NPSs were collected from 461 children. The prevalence of S. pneumoniae and S. aureus was similar between children from the azithromycin and placebo arms (85.0% vs 82.1%; odds ratio [OR], 1.23 [95% confidence interval {CI}, .73–2.08] for S. pneumoniae and 21.7% vs 21.3%; OR, 1.02 [95% CI, .64–1.64] for S. aureus). Prevalence of azithromycin-resistant S. pneumoniae was similar in both arms (1.8% vs 0.9% in children from the azithromycin and placebo arms, respectively; OR, 2.10 [95% CI, .30–23.38]); resistance to other antibiotics was also similar between arms. For S. aureus, there was no difference in azithromycin resistance between children in the azithromycin (3.1%) and placebo (2.6%) arms (OR, 1.22 [95% CI, .35–4.47]) or resistance to any other antibiotics. CONCLUSIONS: The higher prevalence of S. aureus azithromycin resistance observed among women treated during labor and their babies 4 weeks after treatment had waned 12 months after delivery. Azithromycin intervention did not induce other antibiotic resistance to S. pneumoniae or S. aureus. CLINICAL TRIALS REGISTRATION: NCT01800942. Oxford University Press 2018-10-15 2018-03-28 /pmc/articles/PMC6160601/ /pubmed/29608659 http://dx.doi.org/10.1093/cid/ciy254 Text en © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Articles and Commentaries
Bojang, Abdoulie
Camara, Bully
Jagne Cox, Isatou
Oluwalana, Claire
Lette, Kodou
Usuf, Effua
Bottomley, Christian
Howden, Benjamin P
D’Alessandro, Umberto
Roca, Anna
Long-term Impact of Oral Azithromycin Taken by Gambian Women During Labor on Prevalence and Antibiotic Susceptibility of Streptococcus pneumoniae and Staphylococcus aureus in Their Infants: Follow-up of a Randomized Clinical Trial
title Long-term Impact of Oral Azithromycin Taken by Gambian Women During Labor on Prevalence and Antibiotic Susceptibility of Streptococcus pneumoniae and Staphylococcus aureus in Their Infants: Follow-up of a Randomized Clinical Trial
title_full Long-term Impact of Oral Azithromycin Taken by Gambian Women During Labor on Prevalence and Antibiotic Susceptibility of Streptococcus pneumoniae and Staphylococcus aureus in Their Infants: Follow-up of a Randomized Clinical Trial
title_fullStr Long-term Impact of Oral Azithromycin Taken by Gambian Women During Labor on Prevalence and Antibiotic Susceptibility of Streptococcus pneumoniae and Staphylococcus aureus in Their Infants: Follow-up of a Randomized Clinical Trial
title_full_unstemmed Long-term Impact of Oral Azithromycin Taken by Gambian Women During Labor on Prevalence and Antibiotic Susceptibility of Streptococcus pneumoniae and Staphylococcus aureus in Their Infants: Follow-up of a Randomized Clinical Trial
title_short Long-term Impact of Oral Azithromycin Taken by Gambian Women During Labor on Prevalence and Antibiotic Susceptibility of Streptococcus pneumoniae and Staphylococcus aureus in Their Infants: Follow-up of a Randomized Clinical Trial
title_sort long-term impact of oral azithromycin taken by gambian women during labor on prevalence and antibiotic susceptibility of streptococcus pneumoniae and staphylococcus aureus in their infants: follow-up of a randomized clinical trial
topic Articles and Commentaries
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160601/
https://www.ncbi.nlm.nih.gov/pubmed/29608659
http://dx.doi.org/10.1093/cid/ciy254
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