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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Risk factors and course of illness among children with invasive penicillin-resistant Streptococcus pneumoniae.The Streptococcus pneumoniae Working Group.
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Risk factors and course of illness among children with invasive penicillin-resistant Streptococcus pneumoniae.The Streptococcus pneumoniae Working Group.

机译：侵袭性青霉素耐药的肺炎链球菌患儿的危险因素和病程。肺炎链球菌工作组。

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OBJECTIVES: To assess differences in risk factors, clinical presentation, and course of illness between children infected with penicillin-sensitive and drug-resistant Streptococcus pneumoniae (DRSP). DESIGN: A retrospective cohort study conducted in Uruguay and Argentina using information from a hospital-based surveillance system. Hospitalized children 5 years of age and younger who had S pneumoniae isolated from a normally sterile site between June 1993 and October 1996 were eligible. Hospital records were linked with surveillance data. Both stratified univariate analysis and logistic regression was completed. RESULTS: Of the 380 children eligible for the study, 274 records (72%) were available for review. Ninety-nine children (36%) had DRSP; 46 showed intermediate susceptibility (minimum inhibitory concentration, 0.12-1.0 microg/mL) and 53 showed high-level resistance (minimum inhibitory concentration >/=2.0 microg/mL). Children with meningitis were less likely to have DRSP than those with other forms of invasive disease (relative risk = 0. 5; 95% confidence interval [CI], 0.2-0.9). Risk factors associated with DRSP were use of penicillin or ampicillin in the 3 months before illness (odds ratio = 2.9; 95% CI, 1.5-5.7) and possession of private medical coverage (odds ratio = 2.4; 95% CI, 1.2-5.0). Response to therapy, including response to penicillin or ampicillin among children with nonmeningeal invasive disease, course of illness, and clinical outcome did not differ significantly between children infected with penicillin-susceptible or penicillin-resistant isolates. CONCLUSION: In this study, previous use of penicillin or ampicillin and private medical coverage were associated with having DRSP. Children with nonmeningeal invasive disease responded equally well to penicillin regardless of the penicillin susceptibility of their pneumococcal isolate.
机译：目的：评估感染青霉素敏感和耐药的肺炎链球菌（DRSP）患儿的危险因素，临床表现和病程的差异。设计：使用来自医院监控系统的信息，在乌拉圭和阿根廷进行了一项回顾性队列研究。在1993年6月至1996年10月之间从正常无菌场所分离出的肺炎链球菌的5岁及以下住院儿童符合资格。医院记录与监测数据相关联。分层单变量分析和逻辑回归均已完成。结果：在380名符合研究条件的儿童中，有274条记录（占72％）可供审查。 99名儿童（36％）患有DRSP; 46表示中等敏感性（最低抑菌浓度，0.12-1.0 microg / mL），53表示高水平耐药性（最低抑菌浓度> / = 2.0 microg / mL）。与其他形式的浸润性疾病的患儿相比，脑膜炎的患儿患DRSP的可能性较小（相对风险= 0。5; 95％置信区间[CI]，0.2-0.9）。与DRSP相关的危险因素是患病前3个月使用青霉素或氨苄青霉素（赔率= 2.9; 95％CI，1.5-5.7）和拥有私人医疗保险（赔率= 2.4; 95％CI，1.2-5.0） ）。在感染了青霉素易感或耐青霉素的儿童中，非脑膜浸润性疾病儿童对治疗的反应（包括对青霉素或氨苄青霉素的反应），病程和临床结局无明显差异。结论：在这项研究中，以前使用青霉素或氨苄青霉素以及私人医疗保险与DRSP有关。无论肺炎球菌分离株对青霉素的敏感性如何，患有非脑膜浸润性疾病的儿童对青霉素的反应均相同。

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