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Background  Antimicrobial resistance (AMR) is an increasing public health problem worldwide.  We studied some patient-related factors that might influence the antimicrobial resistance.  and whether the volume of antibiotic prescribing of the primary care physicians correlate with the antibiotic resistance rates of commensal nasal  Staphylococcus aureus  and  Streptococcus pneumoniae .    Methods  The socio-demographic questionnaires, the antibiotic prescription and resistance data of commensal nasal  S. aureus  and  S. pneumoniae  were collected in the 20 participating Hungarian practices of the APRES study.  Multivariate logistic regression analyses were performed on the patient-related data and the antimicrobial resistance of the  S. aureus  and  S. pneumoniae  on individual, patient level.  Ecological analyses were performed with Spearman’s rank correlations at practice level, the analyses were performed in the whole sample (all practices) and in the cohorts of primary care practices taking care of adults (adult practices) or children (paediatric practices).    Results  According to the multivariate model, age of the patients significantly influenced the antimicrobial resistance of the  S. aureus  (OR = 0.42,  p  = 0.004) and  S. pneumoniae  (OR = 0.89,  p  < 0.001). Living with children significantly increased the AMR of the  S. pneumoniae  (OR = 1.23,  p  = 0.019) .  In the cohorts of adult or paediatric practices, neither the age nor other variables influenced the AMR of the  S. aureus  and  S. pneumoniae .  At practice level, the prescribed volume of penicillins significantly correlated with the resistance rates of the  S. aureus  isolates to penicillin (rho = 0.57,  p  = 0.008). The volume of prescribed macrolides, lincosamides showed positive significant correlations with the  S. pneumoniae  resistance rates to clarithromycin and/or clindamycin in all practices (rho = 0.76,  p  = 0.001) and in the adult practices (rho = 0.63,  p  = 0.021).    Conclusions  The age is an important influencing factor of antimicrobial resistance. The results also suggest that there may be an association between the antibiotic prescribing of the primary care providers and the antibiotic resistance of the commensal  S. aureus  and  S. pneumoniae . The role of the primary care physicians in the appropriate antibiotic prescribing is very important to avoid the antibiotic resistance.

bmc infectious diseases

Patient-related factors, antibiotic prescribing and antimicrobial resistance of the commensal Staphylococcus aureus and Streptococcus pneumoniae in a healthy population - Hungarian results of the APRES study