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首页> 外文期刊>感染症学雑誌 >Efficacy of azithromycin as the empiric therapy in children with community-acquired pneumonia who were isolated macrolide resistant Streptococcus pneumoniae from nasopharynx
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Efficacy of azithromycin as the empiric therapy in children with community-acquired pneumonia who were isolated macrolide resistant Streptococcus pneumoniae from nasopharynx

机译：阿奇霉素作为鼻咽癌分离的肺炎肺炎的儿童审计的疗效疗效

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Identification of pathogens in childhood community-acquired pneumonia (CAP) is not easy. However, it is believed that nasopharyngeal colonization of pathogenic bacteria leads to childhood CAP, so the etiology is inferred by the isolates obtained from nasopharynx of children with CAP. Among the pathogens of childhood CAP, Streptococcus pneumoniae (SP) is the most important agent and macrolides resistant SP (MRSP) is increasingly reported. We investigated the characterization of the mechanism of macrolide resistance in isolates of MRSP by the presence of the ermB gene or the mefA gene and clindamycin (CLDM) resistance. In addition, we also assessed the efficacy of azithromycin (AZM) in children with CAP who were isolated MRSP from nasopharynx. During a 6 month period between January and June in 2002, children with CAP who were treated with a 3 day regimen of AZM and isolated SP from nasopharynx were enrolled. Clinical outcome was based on assessment of fever on the fourth day of treatment. MIC measurements were obtained by broth microdilution and interpreted according to NCCLS criteria. 53 patients were enrolled and MRSP were isolated in 41 children. Of 41 MRSP isolates, 25 isolates were identified CLDM resistance. The AZM MIC90 of CLDM resistant MRSP isolates was 128 microg/ml. On the other hand, that of CLDM sensitive MRSP isolates was 8 microg/ml. However, AZM was effective in 20 children isolated CLDM resistant MRSP and 15 out of 16 children isolated CLDM sensitive MRSP. On this background, despite high rates of MRSP in Japan, AZM continues to be clinically effective for the treatment of childhood CAP.
机译：鉴定儿童社区获得的肺炎（帽）病原体并不容易。然而，据信致病细菌的鼻咽定子导致儿童帽，因此通过从盖帽的鼻咽地获得的分离物推断出病因。在儿童帽的病原体中，肺炎链球菌（SP）是最重要的药剂，耐抗性SP（MRSP）越来越多地报道。我们通过ERMB基因或MEFA基因和Clindamycin（CLDM）抗性，研究了MRSP分离株中的大环内酯抗性机制的表征。此外，我们还评估了阿奇霉素（AZM）在鼻咽中均mrsp的帽子儿童的疗效。在2002年1月至6月至6月的6个月内，注册了用鼻咽和鼻咽嗜来自鼻咽治疗的3天的AZM方案治疗的帽子的儿童。临床结果是基于对治疗第四天的发烧评估。通过肉汤微量稀释获得MIC测量并根据NCCLS标准解释。注册了53名患者，并在41名儿童中孤立MRSP。在41例中，鉴​​定了25个分离株CLDM电阻。 CLDM抗MRSP分离株的AZM MIC90为128 microg / mL。另一方面，CLDM敏感MRSP分离株的CLDM敏感/ mL为8微米。然而，AZM在20名儿童中有效，分离CLDM抗性MRSP和16名儿童中的15名孤立的CLDM敏感MRSP。在这个背景下，尽管日本的MRSP率很高，但AZM继续在临床上有效地治疗儿童帽。

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