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Antibiotic use in Thailand: quantifying impact on blood culture yield and estimates of pneumococcal bacteremia incidence.
- Source :
-
The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2010 Aug; Vol. 83 (2), pp. 301-6. - Publication Year :
- 2010
-
Abstract
- No studies have quantified the impact of pre-culture antibiotic use on the recovery of individual blood-borne pathogens or on population-level incidence estimates for Streptococcus pneumoniae. We conducted bloodstream infection surveillance in Thailand during November 2005-June 2008. Pre-culture antibiotic use was assessed by reported use and by serum antimicrobial activity. Of 35,639 patient blood cultures, 27% had reported pre-culture antibiotic use and 24% (of 24,538 tested) had serum antimicrobial activity. Pathogen isolation was half as common in patients with versus without antibiotic use; S. pneumoniae isolation was 4- to 9-fold less common (0.09% versus 0.37% by reported antibiotic use; 0.05% versus 0.45% by serum antimicrobial activity, P < 0.01). Pre-culture antibiotic use by serum antimicrobial activity reduced pneumococcal bacteremia incidence by 32% overall and 39% in children < 5 years of age. Our findings highlight the limitations of culture-based detection methods to estimate invasive pneumococcal disease incidence in settings where pre-culture antibiotic use is common.
- Subjects :
- Adolescent
Adult
Aged
Anti-Bacterial Agents therapeutic use
Bacteremia drug therapy
Bacteremia epidemiology
Child
Child, Preschool
Drug Utilization
Humans
Incidence
Infant
Middle Aged
Pneumococcal Infections microbiology
Population Surveillance
Streptococcus pneumoniae drug effects
Thailand epidemiology
Young Adult
Anti-Bacterial Agents administration & dosage
Bacteremia microbiology
Pneumococcal Infections epidemiology
Streptococcus pneumoniae isolation & purification
Subjects
Details
- Language :
- English
- ISSN :
- 1476-1645
- Volume :
- 83
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The American journal of tropical medicine and hygiene
- Publication Type :
- Academic Journal
- Accession number :
- 20682872
- Full Text :
- https://doi.org/10.4269/ajtmh.2010.09-0584