Details:

Alternative Title:
PLoS One
Personal Author:
Maher, M. Cyrus ; Alemayehu, Wondu ; Lakew, Takele ; Gaynor, Bruce D. ; Haug, Sara ; ... More +
Maher, M. Cyrus ; Alemayehu, Wondu ; Lakew, Takele ; Gaynor, Bruce D. ; Haug, Sara ; Cevallos, Vicky ; Keenan, Jeremy D. ; Lietman, Thomas M. ; Porco, Travis C. ; Less -
Description:
Background Laboratory studies have suggested that antibiotic resistance may result in decreased fitness in the bacteria that harbor it. Observational studies have supported this, but due to ethical and practical considerations, it is rare to have experimental control over antibiotic prescription rates. Methods and Findings We analyze data from a 54-month longitudinal trial that monitored pneumococcal drug resistance during and after biannual mass distribution of azithromycin for the elimination of the blinding eye disease, trachoma. Prescription of azithromycin and antibiotics that can create cross-resistance to it is rare in this part of the world. As a result, we were able to follow trends in resistance with minimal influence from unmeasured antibiotic use. Using these data, we fit a probabilistic disease transmission model that included two resistant strains, corresponding to the two dominant modes of resistance to macrolide antibiotics. We estimated the relative fitness of these two strains to be 0.86 (95% CI 0.80 to 0.90), and 0.88 (95% CI 0.82 to 0.93), relative to antibiotic-sensitive strains. We then used these estimates to predict that, within 5 years of the last antibiotic treatment, there would be a 95% chance of elimination of macrolide resistance by intra-species competition alone. Conclusions Although it is quite possible that the fitness cost of macrolide resistance is sufficient to ensure its eventual elimination in the absence of antibiotic selection, this process takes time, and prevention is likely the best policy in the fight against resistance.
Subject:
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Algorithms
Analysis Of Variance
Anti-Bacterial Agents
Azithromycin
Bacterial Proteins
Drug Resistance, Bacterial
Genetic Association Studies
Humans
Membrane Proteins
Microbial Viability
Models, Genetic
Pneumococcal Infections
Prevalence
Streptococcus Pneumoniae
Trachoma

Source:
PLoS One. 2012; 7(1).
Document Type:
Journal Article ;
Place as Subject:
Ethiopia ;
Collection(s):
CDC Public Access
Main Document Checksum:
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urn:sha256:2c0a323526a58f6245a16fb76fcb26126f21d555c564d9072c17318ab677d5ca
File Type:

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