Resistencia de Streptococcus pneumoniæ a penicilina y su asociación con factores clínicos y epidemiológicos: Clinical and epidemiological aspects

Background: Penicillin and third generation cephalosporin resistant pneumococcal isolates have emerged in Chile, mainly in the pediatric population. These isolates complicate therapeutic alternatives, specially among patients with central nervous system infections. Aim: To assess the frequency of pe...

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Autores principales:	Contreras M,Lily, Fica C,Alberto, Figueroa C,Oscar, Enríquez O,Nancy, Urrutia H,Paula, Herrera L,Patricio
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2002
Materias:	Penicillin resistance Pneumococcal infections Streptococcus pneumoniæ
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000100004
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spelling	oai:scielo:S0034-988720020001000042002-04-09Resistencia de Streptococcus pneumoniæ a penicilina y su asociación con factores clínicos y epidemiológicos: Clinical and epidemiological aspectsContreras M,LilyFica C,AlbertoFigueroa C,OscarEnríquez O,NancyUrrutia H,PaulaHerrera L,Patricio Penicillin resistance Pneumococcal infections Streptococcus pneumoniæ Background: Penicillin and third generation cephalosporin resistant pneumococcal isolates have emerged in Chile, mainly in the pediatric population. These isolates complicate therapeutic alternatives, specially among patients with central nervous system infections. Aim: To assess the frequency of penicillin and third generation cephalosporin resistance among isolates obtained from pediatric patients with invasive pneumococcal infections, and to study serotypes and clinical risk factors associated with resistance. Material and methods: Microbiological isolates obtained from children between April 1994 and May 1999 with pneumococcal invasive infections, were serotyped and analyzed according to their susceptibility to penicillin and cefotaxime by E-test and broth microdilution testing. Potential risk factors studied included patient's age, previous antibiotic use or admissions, comorbidity, and serotypes. Results: Seventy eight patients were studied. Penicillin-resistant pneumococcal isolates were detected in 35.9% of cases (21.8% with intermediate and 14.1% with high level resistance) without significant variation among different clinical conditions. Most of the high level penicillin-resistant pneumoccocal isolates had MIC ≥4 µg/mL (8 out of 11 strains). One third of penicillin-resistant isolates also expressed cefotaxime resistance. Multivariate analysis indicated an age ≤36 months (OR=6.8; IC 95%: 1.4 to 33.5) and serotype 14 (OR=6.3; IC 95%: 1.7 to 23.3) as factors associated with penicillin resistance. Conclusions: One third of the invasive pneumococcal isolates obtained from pediatric patients were resistant to penicillin. Risk factors involved a younger age and pneumococcal isolates belonging to serotype 14 (Rev Méd Chile 2002; 130: 26-34)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.130 n.1 20022002-01-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000100004es10.4067/S0034-98872002000100004
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Penicillin resistance Pneumococcal infections Streptococcus pneumoniæ
spellingShingle	Penicillin resistance Pneumococcal infections Streptococcus pneumoniæ Contreras M,Lily Fica C,Alberto Figueroa C,Oscar Enríquez O,Nancy Urrutia H,Paula Herrera L,Patricio Resistencia de Streptococcus pneumoniæ a penicilina y su asociación con factores clínicos y epidemiológicos: Clinical and epidemiological aspects
description	Background: Penicillin and third generation cephalosporin resistant pneumococcal isolates have emerged in Chile, mainly in the pediatric population. These isolates complicate therapeutic alternatives, specially among patients with central nervous system infections. Aim: To assess the frequency of penicillin and third generation cephalosporin resistance among isolates obtained from pediatric patients with invasive pneumococcal infections, and to study serotypes and clinical risk factors associated with resistance. Material and methods: Microbiological isolates obtained from children between April 1994 and May 1999 with pneumococcal invasive infections, were serotyped and analyzed according to their susceptibility to penicillin and cefotaxime by E-test and broth microdilution testing. Potential risk factors studied included patient's age, previous antibiotic use or admissions, comorbidity, and serotypes. Results: Seventy eight patients were studied. Penicillin-resistant pneumococcal isolates were detected in 35.9% of cases (21.8% with intermediate and 14.1% with high level resistance) without significant variation among different clinical conditions. Most of the high level penicillin-resistant pneumoccocal isolates had MIC ≥4 µg/mL (8 out of 11 strains). One third of penicillin-resistant isolates also expressed cefotaxime resistance. Multivariate analysis indicated an age ≤36 months (OR=6.8; IC 95%: 1.4 to 33.5) and serotype 14 (OR=6.3; IC 95%: 1.7 to 23.3) as factors associated with penicillin resistance. Conclusions: One third of the invasive pneumococcal isolates obtained from pediatric patients were resistant to penicillin. Risk factors involved a younger age and pneumococcal isolates belonging to serotype 14 (Rev Méd Chile 2002; 130: 26-34)
author	Contreras M,Lily Fica C,Alberto Figueroa C,Oscar Enríquez O,Nancy Urrutia H,Paula Herrera L,Patricio
author_facet	Contreras M,Lily Fica C,Alberto Figueroa C,Oscar Enríquez O,Nancy Urrutia H,Paula Herrera L,Patricio
author_sort	Contreras M,Lily
title	Resistencia de Streptococcus pneumoniæ a penicilina y su asociación con factores clínicos y epidemiológicos: Clinical and epidemiological aspects
title_short	Resistencia de Streptococcus pneumoniæ a penicilina y su asociación con factores clínicos y epidemiológicos: Clinical and epidemiological aspects
title_full	Resistencia de Streptococcus pneumoniæ a penicilina y su asociación con factores clínicos y epidemiológicos: Clinical and epidemiological aspects
title_fullStr	Resistencia de Streptococcus pneumoniæ a penicilina y su asociación con factores clínicos y epidemiológicos: Clinical and epidemiological aspects
title_full_unstemmed	Resistencia de Streptococcus pneumoniæ a penicilina y su asociación con factores clínicos y epidemiológicos: Clinical and epidemiological aspects
title_sort	resistencia de streptococcus pneumoniæ a penicilina y su asociación con factores clínicos y epidemiológicos: clinical and epidemiological aspects
publisher	Sociedad Médica de Santiago
publishDate	2002
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000100004
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Resistencia de Streptococcus pneumoniæ a penicilina y su asociación con factores clínicos y epidemiológicos: Clinical and epidemiological aspects

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