Metlay Joshua P, Fishman Neil O, Joffe Marshall M, Kallan Michael J, Chittams Jesse L, Edelstein Paul H
Center for Clinical Epidemiology and Biostatistics, Philadelphia Veterans Affairs Medical Center, 423 Guardian Drive, Philadelphia, PA 19104, USA.
Emerg Infect Dis. 2006 Aug;12(8):1223-30. doi: 10.3201/eid1708.060017.
We conducted a case-control study of adults with bacteremic pneumococcal pneumonia to identify factors associated with macrolide resistance. Study participants were identified through population-based surveillance in a 5-county region surrounding Philadelphia. Forty-three hospitals contributed 444 patients, who were interviewed by telephone regarding potential risk factors. In multivariable analyses, prior exposure to a macrolide antimicrobial agent (odds ratio [OR] 2.8), prior flu vaccination (OR 2.0), and Hispanic ethnicity (OR 4.1) were independently associated with an increased probability of macrolide resistance, and a history of stroke was independently associated with a decreased probability of macrolide resistance (OR 0.2). Fifty-five percent of patients with macrolide-resistant infections reported no antimicrobial drug exposure in the preceding 6 months. Among patients who reported taking antimicrobial agents in the 6 months preceding infection, failure to complete the course of prescribed drugs was associated with an increased probability of macrolide resistance (OR 3.4).
我们对患有菌血症性肺炎的成年人进行了一项病例对照研究，以确定与大环内酯类耐药相关的因素。研究参与者是通过对费城周边5个县地区的人群监测确定的。43家医院提供了444名患者，通过电话询问他们关于潜在风险因素的情况。在多变量分析中，先前接触过大环内酯类抗菌药物（比值比[OR]为2.8）、先前接种过流感疫苗（OR为2.0）以及西班牙裔种族（OR为4.1）与大环内酯类耐药可能性增加独立相关，而中风病史与大环内酯类耐药可能性降低独立相关（OR为0.2）。55%的大环内酯类耐药感染患者报告在之前6个月内未接触过抗菌药物。在感染前6个月内报告服用过抗菌药物的患者中，未完成规定疗程与大环内酯类耐药可能性增加相关（OR为3.4）。
