Longitudinal Nasopharyngeal Carriage and Antibiotic Resistance of Respiratory Bacteria in Indigenous Australian and Alaska Native Children with Bronchiectasis

Hare, Kim M., Singleton, Rosalyn J., Grimwood, Keith, Valery, Patricia C., Cheng, Allen C., Morris, Peter S., Leach, Amanda J., Smith-Vaughan, Heidi C., Chatfield, Mark, Redding, Greg, Reasonover, Alisa L., McCallum, Gabrielle B., Chikoyak, Lori, McDonald, Malcolm I., Brown, Ngiare, Torzillo, Paul J. and Chang, Anne B. (2013) Longitudinal Nasopharyngeal Carriage and Antibiotic Resistance of Respiratory Bacteria in Indigenous Australian and Alaska Native Children with Bronchiectasis. Plos One, 8 8: e70478.1-e70478.8. doi:10.1371/journal.pone.0070478


Author Hare, Kim M.
Singleton, Rosalyn J.
Grimwood, Keith
Valery, Patricia C.
Cheng, Allen C.
Morris, Peter S.
Leach, Amanda J.
Smith-Vaughan, Heidi C.
Chatfield, Mark
Redding, Greg
Reasonover, Alisa L.
McCallum, Gabrielle B.
Chikoyak, Lori
McDonald, Malcolm I.
Brown, Ngiare
Torzillo, Paul J.
Chang, Anne B.
Title Longitudinal Nasopharyngeal Carriage and Antibiotic Resistance of Respiratory Bacteria in Indigenous Australian and Alaska Native Children with Bronchiectasis
Journal name Plos One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2013-08-01
Sub-type Article (original research)
DOI 10.1371/journal.pone.0070478
Open Access Status DOI
Volume 8
Issue 8
Start page e70478.1
End page e70478.8
Total pages 9
Place of publication San Francisco, CA United States
Publisher Public Library of Science
Language eng
Formatted abstract
Background: Indigenous children in Australia and Alaska have very high rates of chronic suppurative lung disease (CSLD)/
bronchiectasis. Antibiotics, including frequent or long-term azithromycin in Australia and short-term beta-lactam therapy in
both countries, are often prescribed to treat these patients. In the Bronchiectasis Observational Study we examined over
several years the nasopharyngeal carriage and antibiotic resistance of respiratory bacteria in these two PCV7-vaccinated
populations.

Methods:
Indigenous children aged 0.5–8.9 years with CSLD/bronchiectasis from remote Australia (n = 79) and Alaska
(n = 41) were enrolled in a prospective cohort study during 2004–8. At scheduled study visits until 2010 antibiotic use in the
preceding 2-weeks was recorded and nasopharyngeal swabs collected for culture and antimicrobial susceptibility testing.
Analysis of respiratory bacterial carriage and antibiotic resistance was by baseline and final swabs, and total swabs by year.

Results: Streptococcus pneumoniae carriage changed little over time. In contrast, carriage of Haemophilus influenzae declined and Staphylococcus aureus increased (from 0% in 2005–6 to 23% in 2010 in Alaskan children); these changes were associated with increasing age. Moraxella catarrhalis carriage declined significantly in Australian, but not Alaskan, children (from 64% in 2004–6 to 11% in 2010). While beta-lactam antibiotic use was similar in the two cohorts, Australian children received more azithromycin. Macrolide resistance was significantly higher in Australian compared to Alaskan children, while H. influenzae beta-lactam resistance was higher in Alaskan children. Azithromycin use coincided significantly with reduced carriage of S. pneumoniae, H. influenzae and M. catarrhalis, but increased carriage of S. aureus and macrolide-resistant strains of S. pneumoniae and S. aureus (proportion of carriers and all swabs), in a ‘cumulative dose-response’ relationship.

Conclusions:
Over time, similar (possibly age-related) changes in nasopharyngeal bacterial carriage were observed in
Australian and Alaskan children with CSLD/bronchiectasis. However, there were also significant frequency-dependent
differences in carriage and antibiotic resistance that coincided with azithromycin use.
Keyword Cystic Fibrosis Bronchiectasis
Randomized Controlled Trials
Streptococcus pneumoniae
Staphylococcus aureus
Haemophilus influenzae
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
Queensland Children's Medical Research Institute Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 13 times in Thomson Reuters Web of Science Article | Citations
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