1887

Abstract

. is an important but insufficiently studied respiratory pathogen.

. To determine antibiotic susceptibility and impact of recent antibiotics on from children with chronic endobronchial suppuration.

. We cultured nasopharyngeal (NP) swabs and bronchoalveolar lavage (BAL) fluids collected from children who were prospectively enrolled in studies of chronic cough and had flexible bronchoscopy performed. Recent -lactam or macrolide antibiotic use was recorded. isolates stored at −80 °C were re-cultured and susceptibility determined to a range of antibiotics including the macrolide antibiotic erythromycin.

. Data from concurrently collected NP and BAL specimens were available from 547 children (median age 2.4 years) enrolled from 2007 to 2016. NP carriage was detected in 149 (27  %) children and lower airway infection (≥10 c.f.u. ml BAL) in 67 (12  %) children. In total, 91  % of 222 . isolates were -lactamase producers, and non-susceptibility was high to benzylpenicillin (98 %), cefaclor (39 %) and cotrimoxazole (38 %). Overall, >97  % isolates were susceptible to cefuroxime, chloramphenicol, erythromycin and tetracycline; three isolates were erythromycin-resistant (MIC >0.5 mg l). Recent macrolide antibiotics (=152 children, 28 %) were associated with significantly reduced carriage and lower airway infection episodes compared to children who did not receive macrolides; odds ratios 0.19 (95  % CI 0.10–0.35) and 0.15 (0.04–0.41), respectively.

. Despite the frequent use of macrolides, few macrolide-resistant isolates were detected. This suggests a fitness cost associated with macrolide resistance in . Macrolide antibiotics remain an effective choice for treating lower airway infection in children with chronic endobronchial suppuration.

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2019-08-01
2019-09-15
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