STI Unit, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Clinical Reference Laboratory, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Int J STD AIDS. 2024 Jul;35(8):658-661. doi: 10.1177/09564624241246301. Epub 2024 Apr 12.
Tetracycline and macrolide resistance are frequently linked in streptococci and other species. We aimed to assess the association between doxycycline use and azithromycin MICs in oral streptococci.
Linear regression was used to assess the association between doxycycline use in the prior year and the median MIC per participant of oral streptococcal colonies isolated at the baseline visit of the ResistAZM study. The analysis controlled for receipt of other antimicrobials as well as time since antimicrobial consumption.
Fifty-six individual colonies confirmed to be streptococci were isolated from 19 individuals at baseline. The azithromycin MICs of these isolates varied considerably between 0.25 mg/L and >256 mg/L (median 28 mg/L; IQR 1-192 mg/L). The consumption of doxycycline in the preceding 12 months was positively associated with median streptococcal azithromycin MIC (coef. 151.6 [95% CI 10.6-292.7]; = .037).
This post-hoc analysis found that doxycycline use was associated with streptococcal azithromycin susceptibility. Numerous limitations of the study design mean that this study is best considered hypothesis generating. Prospective studies are required to assess if the use of doxycycline could select for macrolide resistance in oral streptococci.
四环素和大环内酯类抗生素耐药性在链球菌和其他物种中经常相关。我们旨在评估在口腔链球菌中使用强力霉素与阿奇霉素 MIC 之间的关联。
线性回归用于评估在前一年使用强力霉素与 ResistAZM 研究基线访视时分离的口腔链球菌菌落每位参与者的中位 MIC 之间的关联。该分析控制了其他抗菌药物的使用以及抗菌药物使用后的时间。
从 19 名参与者的基线处分离出 56 株确认为链球菌的个体菌落。这些分离株的阿奇霉素 MIC 差异很大，范围为 0.25mg/L 至>256mg/L（中位数 28mg/L；IQR 1-192mg/L）。在前 12 个月内使用强力霉素与中位链球菌阿奇霉素 MIC 呈正相关（系数 151.6 [95% CI 10.6-292.7]； =.037）。
这项事后分析发现，强力霉素的使用与链球菌对阿奇霉素的敏感性有关。研究设计的诸多限制意味着这项研究最好被认为是产生假说。需要前瞻性研究来评估强力霉素的使用是否会导致口腔链球菌对大环内酯类抗生素的耐药性。
