Oishi Tomohiro, Sunakawa Keisuke
Department of Infection, School of Medicine, Kitasato University.
Kansenshogaku Zasshi. 2007 Jul;81(4):449-55. doi: 10.11150/kansenshogakuzasshi1970.81.449.
We previously reported that penicillin-resistant Streptococcus pneumoniae (PRSP) and beta-lactamase-nonproducing ampicillin-resistant (BLNAR) were detected at a frequency of 27% and 35% in 468 strains of Streptococcus pneumoniae and 557 strains of Haemophilus influenzae isolated from pediatric patients diagnosed with respiratory infection in 20 pediatric outpatient facilities throughout Japan between November 2002 and June 2003. Here, we have added additional considerations regarding results of nasopharyngeal culture from 558 pediatric patients diagnosed with pneumonia, bronchitis, or otitis media and having no previous history of antibacterial drug administration. No significant difference was seen in the detection of S. pneumoniae or H. influenzae between nasal and oral specimens, or between patients with pneumonia, bronchitis, and otitis media. The detection of S. pneumoniae in pediatric patients 4 years old was significantly higher, however than that in pediatric patients 5 years old. The detection of H. influenzae in pediatric patients with a history of attending group childcare facilities was significantly higher than that in pediatric patients with no such history. No significant differences were seen among groups in the percentage of PSRP and BLNAR isolated among S. pneumoniae and H. influenzae strains. Nasopharyngeal culture of pediatric patients with respiratory infection yielded a higher frequency of S. pneumoniae in younger than older patients and a higher frequency of H. influenzae in pediatric patients with a history of attending group childcare facilities. The detection of resistant bacteria was considered related to other factors, such as the type of antibacterial drugs used, that are not discussed here.
我们之前报道过，在2002年11月至2003年6月期间，从日本全国20家儿科门诊设施中诊断为呼吸道感染的儿科患者分离出的468株肺炎链球菌和557株流感嗜血杆菌中，青霉素耐药肺炎链球菌（PRSP）和非产β-内酰胺酶氨苄西林耐药菌（BLNAR）的检出率分别为27%和35%。在此，我们补充了对558例诊断为肺炎、支气管炎或中耳炎且既往无抗菌药物使用史的儿科患者鼻咽培养结果的进一步考量。在肺炎链球菌或流感嗜血杆菌的检出方面，鼻拭子和咽拭子标本之间、肺炎、支气管炎和中耳炎患者之间均未观察到显著差异。然而，4岁儿科患者中肺炎链球菌的检出率显著高于5岁儿科患者。有集体托育机构入托史的儿科患者中流感嗜血杆菌的检出率显著高于无此病史的儿科患者。在肺炎链球菌和流感嗜血杆菌菌株中分离出的PRSP和BLNAR的百分比在各年龄组之间未观察到显著差异。呼吸道感染儿科患者的鼻咽培养显示，年龄较小的患者中肺炎链球菌的检出率较高，有集体托育机构入托史的儿科患者中流感嗜血杆菌的检出率较高。耐药菌检出被认为与其他因素有关，如所用抗菌药物的类型，本文对此未作讨论。
