Penicillin-nonsusceptible Streptococcus pneumoniae infections in children.
Penicillin-nonsusceptible Streptococcus pneumoniae infections in children.
复制标题
儿童对青霉素不敏感的肺炎链球菌感染。
DOI：
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发表时间：
1999
期刊：
影响因子：
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通讯作者：
L. Huang
中科院分区：
文献类型：
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作者：
C. Y. Lu;P. Lee;P. Hsueh;S. Chang;T. Chiu;H. Lin;C. Y. Lee;L. Huang
青霉素不敏感肺炎链球菌（PNSSP）的出现给临床带来了新的挑战。在台湾，关于儿童PNSSP感染的患病率和临床特征的报道有限。本研究回顾了1993年1月至1998年7月在某医疗中心从17岁以下患者身上获得的所有临床分离肺炎链球菌的耐药模式。分析其临床特点及治疗效果，特别关注侵袭性PNSSP感染患者。共从168例17岁以下患者中分离出170株肺炎链球菌。其中鼻窦炎56例（含菌血症4例）、肺炎44例（含菌血症或脓胸23例）、中耳炎23例（含菌血症5例）、单纯性菌血症9例、结膜炎9例、脑膜炎8例、腹膜炎4例、皮肤感染3例，其余14例为定植。经盘片扩散法检测，111株（65.3%）青霉素敏感性降低。1993年27.3%（3/11）、1994年37.5%（9/24）、1995年55.5%（10/18）、1996年77.5%（31/40）、1997年66.0%（31/47）、1998年87.1%（27/31）。最小抑菌浓度（MIC）测定结果显示部分菌株具有中等耐药性。既往抗生素使用与PNSSP感染的较高发生率相关。然而，大多数儿童对抗菌药物治疗反应良好。
The emergence of penicillin-nonsusceptible Streptococcus pneumoniae (PNSSP) has brought a new clinical challenge. In Taiwan, reports of the prevalence and clinical features of PNSSP infections in children are limited. This study reviewed the resistance patterns of all clinical isolates of S. pneumoniae obtained from patients under 17 years of age from January 1993 through July 1998 in a medical center. Their clinical features and treatment responses were analyzed, with special attention paid to those patients with invasive PNSSP infections. Totally, 170 clinical isolates of S. pneumoniae were obtained from 168 patients aged under 17 years. Among those infections, there were 56 sinusitis (including 4 sinusitis with bacteremia), 44 pneumonia (including 23 pneumonia with bacteremia or empyema), 23 otitis media (including 5 otitis media with bacteremia), 9 simple bacteremia, 9 conjunctivitis, 8 meningitis, 4 peritonitis, 3 skin infections and the other 14 isolates were colonization. One hundred eleven isolates (65.3%) showed reduced penicillin susceptibility by the disk diffusion method. A trend of increasing percentiles of PRSP was noted: 27.3% (3/11) in 1993, 37.5% (9/24) in 1994, 55.5% (10/18) in 1995, 77.5% (31/40) in 1996, 66.0% (31/47) in 1997, and 87.1% (27/31) in 1998. Minimum inhibitory concentration (MIC) determinations by the E-test showed some of the isolates were intermediately resistant. Prior antibiotic usage was associated with a higher incidence of PNSSP infections. However, most children responded well to antimicrobial treatment.