Sharon B Meropol1,2,3, Michael R Jacobs4,5, Kurt C Stange2,5,6,7,8,9, Saralee Bajaksouzian4, Robert A Bonomo5,10,11,12. 1. Department of Pediatrics, Case Western Reserve School of Medicine, Cleveland, Ohio, USA. 2. Department of Population and Quantitative Health Sciences, Case Western Reserve School of Medicine, Cleveland, Ohio, USA. 3. Center for Child Health and Policy, Case Western Reserve School of Medicine, Rainbow Babies and Children's Hospital, and University Hospitals of Cleveland, Cleveland, Ohio, USA. 4. Department of Pathology, Case Western Reserve School of Medicine, Cleveland, Ohio, USA. 5. Department of Medicine, Case Western Reserve School of Medicine, Cleveland, Ohio, USA. 6. Department of Family Medicine & Community Health, Case Western Reserve School of Medicine, Cleveland, Ohio, USA. 7. Case Comprehensive Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio, USA. 8. Department of Sociology, Case Western Reserve School of Medicine, Cleveland, Ohio, USA. 9. Center for Community Health Integration, Case Western Reserve School of Medicine, Cleveland, Ohio, USA. 10. Department of Pharmacology, Case Western Reserve School of Medicine, Cleveland, Ohio, USA. 11. Department of Molecular Biology and Microbiology, Case Western Reserve School of Medicine, Cleveland, Ohio, USA. 12. Louis Stokes Cleveland Veterans Affairs Medical Center Cleveland, Ohio, USA.
Abstract
BACKGROUND: The objective of this study was to characterize longitudinal colonization with Streptococcus pneumoniae during the first year of life within a community newborn infant cohort, and assess the relationship between antibiotic exposure and colonization with antibiotic-resistant organisms. METHODS: During April 2013-February 2014, 326 infants were enrolled from an urban academic hospital well-baby nursery. At ages 4, 8, and 12 months, we collected antibiotic data, other exposure data, and nasopharyngeal cultures for pneumococcal isolation. RESULTS: Follow-up visits were completed for 211, 158, and 144 infants at ages 4, 8, and 12 months, respectively. By 12 months, 33% of infants attending the visits had ever been exposed to antibiotics, 67% if exposures to maternal antibiotics at birth are included. Pneumococci were isolated at 38/839 (4.5%) visits from 38 infants, including one 13-valent conjugate vaccine (PCV13) serotype (6A). There were 1 (0.3%), 15 (7%), 7 (4%), and 15 (10%) infants who were colonized at 0-, 4-, 8-, and 12-month visits, respectively. By age 12 months, at least 35 (11%) infants had ever been colonized. Sixteen isolates (42%) exhibited nonsusceptibility to at least 1 antibiotic. Infants with recent antibiotic exposure were not more likely to be colonized or to harbor nonsusceptible organisms. CONCLUSIONS: Within a hospital birth cohort followed in the community, pneumococcal colonization and related antibiotic resistance were lower than previously reported, likely associated with PCV13 use. Antibiotic exposure was not associated with subsequent colonization with resistant isolates. The influence of other environmental factors needs further study.
BACKGROUND: The objective of this study was to characterize longitudinal colonization with Streptococcus pneumoniae during the first year of life within a community newborn infant cohort, and assess the relationship between antibiotic exposure and colonization with antibiotic-resistant organisms. METHODS: During April 2013-February 2014, 326 infants were enrolled from an urban academic hospital well-baby nursery. At ages 4, 8, and 12 months, we collected antibiotic data, other exposure data, and nasopharyngeal cultures for pneumococcal isolation. RESULTS: Follow-up visits were completed for 211, 158, and 144 infants at ages 4, 8, and 12 months, respectively. By 12 months, 33% of infants attending the visits had ever been exposed to antibiotics, 67% if exposures to maternal antibiotics at birth are included. Pneumococci were isolated at 38/839 (4.5%) visits from 38 infants, including one 13-valent conjugate vaccine (PCV13) serotype (6A). There were 1 (0.3%), 15 (7%), 7 (4%), and 15 (10%) infants who were colonized at 0-, 4-, 8-, and 12-month visits, respectively. By age 12 months, at least 35 (11%) infants had ever been colonized. Sixteen isolates (42%) exhibited nonsusceptibility to at least 1 antibiotic. Infants with recent antibiotic exposure were not more likely to be colonized or to harbor nonsusceptible organisms. CONCLUSIONS: Within a hospital birth cohort followed in the community, pneumococcal colonization and related antibiotic resistance were lower than previously reported, likely associated with PCV13 use. Antibiotic exposure was not associated with subsequent colonization with resistant isolates. The influence of other environmental factors needs further study.
Authors: Sara Tomczyk; Ruth Lynfield; William Schaffner; Arthur Reingold; Lisa Miller; Susan Petit; Corinne Holtzman; Shelley M Zansky; Ann Thomas; Joan Baumbach; Lee H Harrison; Monica M Farley; Bernard Beall; Lesley McGee; Ryan Gierke; Tracy Pondo; Lindsay Kim Journal: Clin Infect Dis Date: 2016-02-07 Impact factor: 9.079
Authors: Lauri A Hicks; Monina G Bartoces; Rebecca M Roberts; Katie J Suda; Robert J Hunkler; Thomas H Taylor; Stephanie J Schrag Journal: Clin Infect Dis Date: 2015-03-05 Impact factor: 9.079
Authors: Julie Y Zhou; Megan Isaacson-Schmid; Elizabeth C Utterson; Elizabeth M Todd; Michelle McFarland; Janardan Sivapalan; Joan M Niehoff; Carey-Ann D Burnham; S Celeste Morley Journal: Int J Infect Dis Date: 2015-09-03 Impact factor: 3.623
Authors: Jonathan A Finkelstein; Susan S Huang; James Daniel; Sheryl L Rifas-Shiman; Ken Kleinman; Donald Goldmann; Stephen I Pelton; Alfred DeMaria; Richard Platt Journal: Pediatrics Date: 2003-10 Impact factor: 7.124
Authors: Sharon B Meropol; Kurt C Stange; Michael R Jacobs; Judith K Weiss; Saralee Bajaksouzian; Robert A Bonomo Journal: Open Forum Infect Dis Date: 2016-12-05 Impact factor: 3.835