Penicillin-Nonsusceptible Streptococcus pneumoniae in Malmö, Sweden. Aspects of Epidemiology, Microbiology and Genetics.

Research output: ThesisDoctoral Thesis (compilation)

Abstract

S. pneumoniae is a major cause of common diseases such as acute otitis media and pneumonia, as well as more serious illnesses like septicemia and meningitis. The increasing level of resistance in pneumococci threatens to change the tradition of treating common respiratory infections with narrow-spectrum penicillin. In the city of Malmö the proportion of penicillin nonsusceptible S. Pneumoniae (PNSP) increased to about 10% at the beginning of the 1990s. In Paper 1 we showed that the emergence of PNSP in Malmö in 1994?1995 was caused by several different clones. Many studies have suggested that day care centers constitute an ecological reservoir of PNSP clones. Among children attending DCCs in the Malmö region, 42% were carriers of S. pneumoniae, and 13% of those children carried PNSP (Paper 2). We found no evidence that the minor variations observed in building or hygiene standards at the DCCs had a significant impact on pneumococcal carriage, but younger age of the children was significantly associated with carriage of pneumococci. The incidence of PNSP cases per 1,000 children was positively correlated with the prescribing of antibiotics in Malmö (Paper 3). Prescribing of antibiotics was positively correlated with the level of income in different residential areas in Malmö. We also observed relatedness of pbp genes in both susceptible and nonsusceptible pneumococci, and horizontal transfer of pbp genes may be one explanation for the spread of resistance to penicillin in pneumococci in Malmö (Paper 5). In conclusion, the proportion of PNSP in Malmö has remained stable since the rapid increase in these bacteria seen in the mid 1990s, despite a steady decrease in the prescribing of antibiotics and an ongoing intervention program (Paper 4).
Original languageEnglish
QualificationDoctor
Awarding Institution
  • Preventive Paediatrics
Supervisors/Advisors
  • Laurell, Martin, Supervisor
Award date2005 Sept 30
Publisher
ISBN (Print)91-85439-79-7
Publication statusPublished - 2005

Bibliographical note

Defence details

Date: 2005-09-30
Time: 13:00
Place: Universitetsklinikernas aula, Ingång 35, Universitetssjukhuset MAS, Malmö.

External reviewer(s)

Name: Örtqvist, Åke
Title: Docent
Affiliation: Smittskyddsenheten KS / Solna

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<div class="article_info">. <span class="article_issue_date">1999</span>. <span class="article_title">Several different clones present during the penetration phase of resistant Streptococcus pneumoniae in the city of Malmo, Sweden.</span> <span class="journal_series_title">Microb Drug Resist.</span>, <span class="journal_volume">vol 5</span> <span class="journal_pages">pp 37-43</span>.</div>
<div class="article_info">. <span class="article_issue_date">2001</span>. <span class="article_title">Carriage of penicillin-resistant S. pneumoniae by children in day-care centers during an intervention program in Malmoe, Sweden.</span> <span class="journal_series_title">Pediat Infect Dis J.</span>, <span class="journal_volume">vol 20</span> <span class="journal_pages">pp 1144-9</span>.</div>
<div class="article_info">. <span class="article_issue_date">2005</span>. <span class="article_title">Impact of Socioeconomic Factors and Antibiotic Prescribing on Penicillin Nonsusceptible S. pneumoniae in the city of Malmo.</span> <span class="journal_series_title">Scand J Infect Dis.</span>, <span class="journal_volume">vol 37</span> <span class="journal_pages">pp 436-441</span>.</div>
<div class="article_info">. <span class="article_issue_date"></span>. <span class="article_title">A 10-year follow-up of penicillin-nonsusceptible S. pneumoniae during an intervention program in Malmö, Sweden.</span> (submitted)</div>
<div class="article_info">. <span class="article_issue_date"></span>. <span class="article_title">Relatedness of penicillin-susceptible and penicillin-nonsusceptible pneumococcal isolates.</span> (manuscript)</div>

Subject classification (UKÄ)

  • Pediatrics

Free keywords

  • Medicine (human and vertebrates)
  • Day-care centers
  • Streptococcus pneumoniae
  • Penicillin-nonsusceptible
  • Medicin (människa och djur)

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