AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan.
Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
PLoS One. 2020 Oct 22;15(10):e0240655. doi: 10.1371/journal.pone.0240655. eCollection 2020.
To examine the association between penicillin susceptibility of Streptococcus pneumoniae and penicillin consumption in Japan.
We used Japan Nosocomial Infection Surveillance data on the susceptibility of S. pneumoniae and sales data obtained from IQVIA Services Japan K.K. for penicillin consumption. We analysed both sets of data by decomposing them into seasonality and chronological trend components. The cross-correlation function was checked using Spearman's rank correlation coefficient to examine the correlation between susceptibility and consumption.
After adjusting for seasonality, the susceptibility of S. pneumoniae to penicillins gradually improved (55.7% in 2013 and 60.6% in 2018, respectively) and penicillin consumption increased during the same period (0.76 defined daily doses per 1,000 inhabitants per day [DID] in 2013, and 0.89 DID in 2018). The results showed positive cross-correlation (coefficient 0.801, p-value < 0.001). In contrast, cephalosporin consumption decreased (3.91 DID in 2013 and 3.19 DID in 2018) and showed negative cross-correlation with susceptibility of S. pneumoniae to penicillins (coefficient -0.981, p-value < 0.001).
The rates of penicillin-susceptible S. pneumoniae isolates did not negatively correlate with penicillin consumption at the population level. Increased penicillin consumption might not impair the penicillin susceptibility of S. pneumoniae.
研究日本肺炎链球菌对青霉素的敏感性与青霉素消耗量之间的关系。
我们使用日本医院感染监测数据中肺炎链球菌的药敏情况和从 IQVIA Services Japan K.K. 获得的青霉素消耗量销售数据。我们通过将两组数据分解为季节性和时间趋势成分来进行分析。使用 Spearman 秩相关系数检查交叉相关函数，以检查敏感性与消耗之间的相关性。
调整季节性因素后，肺炎链球菌对青霉素的敏感性逐渐提高（2013 年为 55.7%，2018 年为 60.6%），同期青霉素消耗量增加（2013 年为 0.76 个每千人口每日限定日剂量[DID]，2018 年为 0.89 DID）。结果显示存在正交叉相关（系数 0.801，p 值<0.001）。相比之下，头孢菌素消耗量下降（2013 年为 3.91 DID，2018 年为 3.19 DID），与肺炎链球菌对青霉素的敏感性呈负交叉相关（系数-0.981，p 值<0.001）。
在人群水平上，青霉素敏感肺炎链球菌分离株的比例与青霉素消耗量没有负相关。增加青霉素的消耗可能不会降低肺炎链球菌对青霉素的敏感性。
