Quinolone Consumption by Mothers Increases Their Children's Risk of Acquiring Quinolone-Resistant Bacteriuria
Quinolone Consumption by Mothers Increases Their Children's Risk of Acquiring Quinolone-Resistant Bacteriuria
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DOI：
10.1093/cid/ciz858
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发表时间：
2020-08-01
影响因子：
11.8
通讯作者：
Chowers, Michal
中科院分区：
文献类型：
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作者：
Gottesman, Bat-Sheva;Low, Marcelo;Chowers, Michal
背景资料。在儿科人群中已经记录了对喹诺酮类药物的耐药性，尽管它们在儿童中的使用有限。本研究调查母体使用喹诺酮类药物对子代革兰氏阴性菌耐药的影响。我们在2010-2017年间进行了一项以人群为基础的、不匹配的病例对照研究。所有病例均为0.5-17岁的儿童，患有社区获得性耐喹诺酮类细菌尿。对照组为患有喹诺酮敏感型细菌尿的相似儿童。只包括每个孩子的第一次阳性尿液培养。收集了分发给母亲的喹诺酮类药物、分发给儿童的任何抗生素、年龄、性别、种族和以前住院的数据。既往使用喹诺酮类药物的儿童被排除在外。研究人群包括40204名儿童。2182例(5.3%)尿培养检出耐喹诺酮类药物。中位年龄为5岁，其中93.7%为女性，77.6%为犹太人。共有26937名(65%)的儿童在菌尿前6个月接受了任何抗生素治疗，1359名母亲(3.2%)接受了喹诺酮类药物的治疗。独立的危险因素是给母亲分发的喹诺酮类药物(优势比[OR]，1.50[95%可信区间{CI}，1.22-1.85])、阿拉伯民族(OR，1.99[95%CI，1.81-2.19])和分发给孩子的抗生素(OR，1.54[95%CI，1.38-1.71])。与12-17岁的儿童相比，年龄较小的儿童患耐喹诺酮类细菌尿的几率增加1.33-1.43。给母亲开的喹诺酮类药物处方与其后代中社区获得的耐喹诺酮类细菌的风险增加了约50%有关。这是使用抗生素的有害生态影响的另一个例子，在开抗生素处方时应该考虑到这一点。
Background. Quinolone resistance has been documented in the pediatric population, although their use is limited in children. This study investigated the effect of maternal quinolone use on gram-negative bacterial resistance to quinolones in their offspring.Methods. We conducted a population-based, unmatched case-control study during 2010-2017. Cases were all children aged 0.5-17 years with community acquired, gram-negative quinolone-resistant bacteriuria. Controls were similar children with quinolone-sensitive bacteriuria. Only the first positive urine cultures for each child were included. Data on quinolones dispensed to the mother, any antibiotics dispensed to the children, age, sex, ethnicity, and prior hospitalizations were collected. Children with previous quinolone use were excluded.Results. The study population consisted of 40 204 children. Quinolone resistance was detected in 2182 (5.3%) urine cultures. The median age was 5 years, with 93.7% females and 77.6% Jewish. A total of 26 937 (65%) of the children received any antibiotic and 1359 (3.2%) of the mothers received quinolones in the 6 months preceding bacteriuria. Independent risk factors were quinolone dispensed to the mothers (odds ratio [OR], 1.50 [95% confidence interval {CI}, 1.22-1.85]), Arab ethnicity (OR, 1.99 [95% CI, 1.81-2.19]), and antibiotic dispensed to the child (OR, 1.54 [95% CI, 1.38-1.71]). Compared with children aged 12-17 years, younger children had 1.33-1.43 increased odds for quinolone-resistant bacteriuria.Conclusions. Quinolone prescription to mothers was linked to increased risk of community-acquired, quinolone-resistant bacteria in their offspring, by about 50%. This is another example of the deleterious ecological effects of antibiotic use and should be considered when prescribing antibiotics.