Emergence of the M Phenotype of Erythromycin-Resistant Pneumococci in South Africa
1998

Emergence of Erythromycin-Resistant Pneumococci in South Africa

Sample size: 9868 publication Evidence: moderate

Author Information

Author(s): Carol A. Widdowson, Keith P. Klugman

Primary Institution: South African Institute for Medical Research

Hypothesis

The study investigates the emergence of the M phenotype of erythromycin-resistant pneumococci in South Africa from 1987 to 1996.

Conclusion

The M phenotype of erythromycin resistance in pneumococci has significantly increased in South Africa over the last decade.

Supporting Evidence

  • Erythromycin-resistant pneumococci have been isolated in South Africa since 1978.
  • Resistance to macrolides was detected in 270 of 9,868 isolates.
  • 89% of erythromycin-resistant strains exhibited resistance to clindamycin.
  • The M phenotype increased significantly from 1 of 5,115 to 28 of 4,735 isolates from 1987 to 1996.

Takeaway

Doctors found that some germs in South Africa are becoming resistant to a medicine called erythromycin, which means it might not work as well to help sick people.

Methodology

The study examined erythromycin-resistant blood and CSF isolates using disk diffusion assays and agar dilution methods.

Potential Biases

Potential bias due to the underrepresentation of private sector data.

Limitations

The study primarily focused on isolates from the public sector, which may not represent the private sector's resistance levels.

Participant Demographics

62% of isolates were from children under 12 years old.

Statistical Information

P-Value

5x10-7

Confidence Interval

95% CI 4.1221

Statistical Significance

p = 5x10-7

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