Batt Sarah L, Charalambous Bambos M, Solomon Anthony W, Knirsch Charles, Massae Patrick A, Safari Salesia, Sam Noel E, Everett Dean, Mabey David C W, Gillespie Stephen H
Department of Medical Microbiology, University College London, Royal Free Campus, London NW3 2PF.
Antimicrob Agents Chemother. 2003 Sep;47(9):2765-9. doi: 10.1128/AAC.47.9.2765-2769.2003.
Community distribution of azithromycin has an important role to play in trachoma control. Previous studies have suggested that this may increase the prevalence of macrolide-resistant Streptococcus pneumoniae. S. pneumoniae was isolated from children under 7 years of age in Rombo District, northern Tanzania, before and 2 and 6 months after community-wide administration of azithromycin. Overall carriage rates were 11, 12, and 7%, respectively. Only one macrolide-resistant isolate carrying the mef gene was obtained 6 months after azithromycin administration. This contrasted with cotrimoxazole and penicillin resistance, both of which were common (cotrimoxazole resistance, 42, 43, and 47%, and penicillin resistance, 21, 17, and 16% at baseline, 2 months, and 6 months, respectively). There was a significant association between cotrimoxazole and penicillin resistance (P < 0.0001, Fisher's exact). These data suggest that in communities where macrolide resistance is rare, azithromycin distribution for trachoma control is unlikely to increase the prevalence of resistant organisms.
阿奇霉素在社区的分发在沙眼控制中发挥着重要作用。先前的研究表明，这可能会增加耐大环内酯类肺炎链球菌的患病率。在坦桑尼亚北部伦博区，对7岁以下儿童在社区广泛施用阿奇霉素之前、之后2个月和6个月分别分离肺炎链球菌。总体携带率分别为11%、12%和7%。阿奇霉素施用6个月后仅获得一株携带mef基因的耐大环内酯类分离株。这与复方新诺明和青霉素耐药形成对比，二者耐药情况均很常见（复方新诺明耐药率在基线、2个月和6个月时分别为42%、43%和47%，青霉素耐药率分别为21%、17%和16%）。复方新诺明和青霉素耐药之间存在显著关联（P<0.0001，Fisher精确检验）。这些数据表明，在耐大环内酯类情况罕见的社区，用于沙眼控制的阿奇霉素分发不太可能增加耐药生物体的患病率。
