Paganini H, Guiñazú J R, Hernández C, Lopardo H, Gonzalez F, Berberian G
Department of Infectious Diseases and Epidemiology, Hospital de Pediatría Profesor Dr. Juan P. Garrahan, Buenos Aires, Argentina.
Int J Infect Dis. 2001;5(2):86-8. doi: 10.1016/s1201-9712(01)90031-1.
To describe the clinical characteristics of pleural empyema in children caused by Streptococcus pneumoniae nonsusceptible to penicillin and compare their clinical outcome with pleural empyemas caused by penicillin-susceptible organisms.
Records of 109 children with complicated pleural effusions between January 1996 and December 1998 were retrospectively reviewed.
Pathogens were recovered in 45 of these cases. Streptococcus pneumoniae represented 71% of the isolates, with 20 (62%) and 12 (38%) of the strains proving susceptible and nonsusceptible to penicillin, respectively. The average age for children with penicillin-nonsusceptible infections was 18.3 months compared with an average age of 40.9 months for those with penicillin-susceptible infections (P = 0.03). Previous antibiotic treatment was more frequent in children with penicillin-nonsusceptible organisms (P = 0.05). No significant differences were found between the two groups for gender, underlying diseases, duration of fever and tachypnea, need of surgical treatment, bacteremia incidence, mean duration of therapy, or length of hospital stay.
Pleural empyemas caused by penicillin-nonsusceptible S. pneumoniae appear to be associated with younger age and previous antibiotic treatment. By contrast, the outcome was not influenced by the penicillin susceptibility of the pneumococcus strains.
描述由对青霉素不敏感的肺炎链球菌引起的儿童胸腔积脓的临床特征，并将其临床结局与由对青霉素敏感的病原体引起的胸腔积脓进行比较。
回顾性分析1996年1月至1998年12月期间109例复杂性胸腔积液患儿的病历。
在其中45例病例中分离出病原体。肺炎链球菌占分离菌株的71%，其中20株（62%）和12株（38%）分别对青霉素敏感和不敏感。青霉素不敏感感染患儿的平均年龄为18.3个月，而青霉素敏感感染患儿的平均年龄为40.9个月（P = 0.03）。青霉素不敏感病原体患儿先前使用抗生素治疗更为频繁（P = 0.05）。两组在性别、基础疾病、发热和呼吸急促持续时间、手术治疗需求、菌血症发生率、平均治疗持续时间或住院时间方面未发现显著差异。
由对青霉素不敏感的肺炎链球菌引起的胸腔积脓似乎与年龄较小和先前使用抗生素治疗有关。相比之下，结局不受肺炎球菌菌株青霉素敏感性的影响。
