Impact of antimicrobial therapy on nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Branhamella catarrhalis in children with respiratory tract infections
Impact of antimicrobial therapy on nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Branhamella catarrhalis in children with respiratory tract infections
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DOI：
10.1086/313981
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发表时间：
2000-08-01
影响因子：
11.8
通讯作者：
Cohen, R
中科院分区：
文献类型：
--
作者：
Varon, E;Levy, C;Cohen, R
我们进行了一项多中心前瞻性研究，以记录抗生素治疗期间鼻咽部携带肺炎链球菌、流感嗜血杆菌和卡他布兰汉菌的变化。对629例呼吸道感染儿童在抗生素治疗前后进行鼻咽采样。采用药敏试验、血清分型、随机引物聚合酶链反应和脉冲场凝胶电泳对治疗前后的菌株进行比较。肺炎。所有3种（特别是S. pneumoniae和B. B.卡他炎）。青霉素耐药肺炎球菌比例（PRP; 66% vs. 44%）的增加是由于青霉素敏感肺炎球菌携带减少（629例中的71例vs. 629例中的176例）。特定儿童携带PRP的风险并未增加。没有一个孩子被发现藏有遗传相关的菌株增加最低抑菌浓度。鉴于PRP的多重耐药性，β-内酰胺类抗生素治疗也增加了大环内酯类耐药菌株的发生率，而大环内酯类选择大环内酯类和青霉素耐药菌株。
We conducted a multicenter prospective study to document changes in nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Branhamella catarrhalis during antibiotic therapy. A cohort of 629 children with respiratory tract infections underwent nasopharyngeal sampling before and after antibiotic treatment. Susceptibility testing, serotyping, arbitrarily primed polymerase chain reaction, and pulsed-field gel electrophoresis were used to compare pretreatment and posttreatment strains of S. pneumoniae. A significant decrease in carriage of all 3 species (especially S. pneumoniae and B. catarrhalis) was recorded. The increase in the proportion of penicillin-resistant pneumococci (PRP; 66% vs. 44%) was due to the decreased carriage of penicillin-susceptible pneumococci (71 of 629 vs. 176 of 629). The risk of PRP carriage in a given child did not increase. None of the children was found to harbor genetically related strains with increased minimum inhibitory concentrations. Given the multiple resistance of PRP, beta-lactam antibiotic therapy also increased the incidence of macrolide-resistant strains, whereas macrolides selected both macrolide- and penicillin-resistant strains.