原创力文档the fitness cost of antibiotic resistance in streptococcus pneumoniae insight from the field抗生素耐药性肺炎链球菌的洞察力的健康成本.pdfVIP
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the fitness cost of antibiotic resistance in streptococcus pneumoniae insight from the field抗生素耐药性肺炎链球菌的洞察力的健康成本
The Fitness Cost of Antibiotic Resistance in
Streptococcus pneumoniae: Insight from the Field
1 2 2 3,4 3 3
M. Cyrus Maher , Wondu Alemayehu , Takele Lakew , Bruce D. Gaynor , Sara Haug , Vicky Cevallos ,
Jeremy D. Keenan3,4, Thomas M. Lietman1,3,4,5, Travis C. Porco1,3,4,5*
1 Department of Epidemiology Biostatistics, University of California San Francisco, San Francisco, California, United States of America, 2 ORBIS International, New York,
New York, United States of America, 3 F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, United States of America, 4 Department of
Ophthalmology, University of California San Francisco, San Francisco, California, United States of America, 5 Institute for Global Health, University of California San
Francisco, San Francisco, California, United States of America
Abstract
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 tra
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