Increasing bacterial resistance in pediatric acute conjunctivitis (1997-1998)
Increasing bacterial resistance in pediatric acute conjunctivitis (1997-1998)
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DOI：
10.1128/aac.44.6.1650-1654.2000
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发表时间：
2000-06-01
影响因子：
4.9
通讯作者：
Stroman, DW
中科院分区：
文献类型：
--
作者：
Block, SL;Hedrick, J;Stroman, DW
为了解儿童结膜炎的主要致病菌流感嗜血杆菌和肺炎链球菌的耐药性，我们于1997年1月和1998年3月对250名来自肯塔基州农村的儿童急性结膜炎患者进行了前瞻性培养，平均年龄为24.3个月。共分离出流感嗜血杆菌106株(占总数的42%)和肺炎链球菌75株(占总数的30%)，无菌生长或无病原体79例(占总数的32%)。87株流感嗜血杆菌中60株(69%)检出β-内酰胺酶，65株肺炎链球菌青霉素敏感株44株(68%)，耐药株17株(26%)，中间株4株(6%)。97例(39%)患者并发结膜炎和急性中耳炎，其中57%的患者流感嗜血杆菌已恢复正常。体外活性以环丙沙星、氧氟沙星、四环素最强，庆大霉素、妥布霉素、多粘菌素B-甲氧苄啶、多粘菌素B-新霉素中等。磺胺甲恶唑对这两种病原菌均无抗菌活性。69%的流感嗜血杆菌产β-内酰胺酶，仍然是引起结膜炎和结膜炎-中耳炎综合征的主要病原体。65例肺炎链球菌结膜炎患者中有32%的患者对青霉素不敏感的S肺炎，且大多数菌株对青霉素耐药。
We sought to determine the current level of resistance in Haemophilus influenzae and Streptococcus pneumoniae, the primary pathogens of pediatric conjunctivitis, Bem-een January 1997 and March 1998, we prospectively cultured acute conjunctivitis in 250 ambulatory pediatric patients from rural Kentucky whose a average age was 24.3 months. In those 250 cases, 106 H. influenzae (42% of the total) and 75 S. pneumoniae (30% of the total) pathogens were isolated, with no growth or no pathogen resulting in 79 cases (32% of the total). Beta-lactamase was detected in 60 (69%) of 87 tested strains of H. influenzae, Among 65 isolates of S. pneumoniae tested for penicillin susceptibility, 44 (68%) were susceptible, 17 (26%) were resistant, and 4 (6%) were intermediate. Conjunctivitis with acute otitis media was observed in 97 patients (39%), and H. influenzae was recovered in 57% of these 97 cases. As for in vitro activity, ciprofloxacin, ofloxacin, and tetracycline were the most active; and gentamicin, tobramycin, polymyxin B-trimethoprim, and polymyxin B-neomycin were intermediately active. Sulfamethoxazole possessed no activity against either pathogen. Beta-lactamase production was detected in 69% of H. influenzae strains, which still remains the primary causative pathogen of both conjunctivitis and conjunctivitis-otitis syndrome. Penicillin-nonsusceptible S, pneumoniae was observed in 32% of 65 patients with S. pneumoniae conjunctivitis, with most strains being penicillin resistant.