Nilsson Percy, Laurell Martin H
Department of Paediatrics, Malmö University Hospital, Lund University, Malmö, Sweden.
Scand J Infect Dis. 2005;37(6-7):436-41. doi: 10.1080/00365540510037795.
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.
携带或感染对青霉素不敏感的肺炎链球菌（PNSP）与抗生素处方、社会经济因素以及日托中心（DCC）的就诊情况有关。在本研究中，采用线性回归来估计这些风险因素与马尔默19个居民区中PNSP病例（对青霉素不敏感定义为MIC =0.5微克/毫升）发病率之间的关系。PNSP病例数与该地区学龄前儿童数量相关（r = 0.950，p < 0.0001）。每1000名儿童中PNSP病例的发病率与抗生素处方呈正相关（r = 0.614，p < 0.01），但与日托中心就诊情况或所研究的任何社会经济因素均无关联。然而，抗生素处方与人均收入呈正相关（r = 0.597，p < 0.05）。因此，即使仅较高的社会经济地位对马尔默PNSP的发病率没有明显影响，但这两个因素之间仍存在间接关系，因为这些地区的居民使用了更多的抗生素。基于这些结果，通过推行关于抗生素处方的限制性政策，似乎能最可靠地限制耐药肺炎球菌的传播。
