Uzuner Arzu, Ilki Arzu, Akman Mehmet, Gündoğdu Ercan, Erbölükbaş Riza, Kokaçya Omer, Mengüç Türkan, Kalaça Sibel, Söyletir Güner
Department of Family Medicine, Marmara University, Istanbul, Turkey.
Turk J Pediatr. 2007 Oct-Dec;49(4):370-8.
Streptococcus pneumoniae carriage is a risk factor for the development of respiratory system infections and the spread of penicillin-resistant strains. The aim of this study was to investigate nasopharyngeal carriage of S. pneumoniae in healthy children and resistance to penicillin and other antimicrobials and to assess related risk factors. Nasopharyngeal specimens collected from healthy children less than six years of age, visiting a Mother and Child Health Center for health control, were investigated microbiologically between February-March 2004. Carriage rate was 37.2% (n=112/301); 33.9% intermediate and 5.4% high penicillin resistance were detected. According to multivariate analysis, carriage rate was inversely related to number of rooms (OR:0.574) and child age (OR:0.978), while penicillin resistance was correlated well with antibiotic use in the last two months (OR:2.193). Decreased sensitivity plus resistance to other antimicrobials were: trimethoprim-sulfamethoxazole (TMP-SMX) 45.6%; erythromycin 16.1%, tetracycline 16.1%; clindamycin 9.8%, and ofloxacin 3.6% in pneumococcal isolates, which increased significantly (p<0.05) to 72.7%, 31.8%, 27.3%, 20.5%, and 6.8%, respectively, in penicillin non-sensitive S. pneumoniae (PNSSP) except for ofloxacin. Overall multidrug resistance was 17.9%, while PNSSP exhibited a resistance rate of 38.6%. In conclusion, S. pneumoniae carriage rates determined in healthy children were high and PNSSP strains also showed increased resistance to other antimicrobials.
肺炎链球菌携带是呼吸系统感染发生及耐青霉素菌株传播的一个危险因素。本研究的目的是调查健康儿童鼻咽部肺炎链球菌的携带情况、对青霉素及其他抗菌药物的耐药性，并评估相关危险因素。于2004年2月至3月间，对前往母婴健康中心进行健康检查的6岁以下健康儿童采集的鼻咽部标本进行了微生物学调查。携带率为37.2%（n = 112/301）；检测到33.9%为中度青霉素耐药，5.4%为高度青霉素耐药。多因素分析显示，携带率与房间数量（OR：0.574）和儿童年龄（OR：0.978）呈负相关，而青霉素耐药与过去两个月内使用抗生素密切相关（OR：2.193）。肺炎球菌分离株对其他抗菌药物的敏感性降低加耐药情况为：甲氧苄啶-磺胺甲恶唑（TMP-SMX）45.6%；红霉素16.1%，四环素16.1%；克林霉素9.8%，氧氟沙星3.6%，除氧氟沙星外，在青霉素不敏感肺炎链球菌（PNSSP）中分别显著增加（p<0.05）至72.7%、31.8%、27.3%、20.5%和6.8%。总体多重耐药率为17.9%，而PNSSP的耐药率为38.6%。总之，健康儿童中确定的肺炎链球菌携带率较高，PNSSP菌株对其他抗菌药物的耐药性也有所增加。
