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墨西哥城三级儿科医院的侵袭性肺炎球菌病:流行病学和死亡风险因素。

Invasive pneumococcal disease in a third level pediatric hospital in Mexico City: epidemiology and mortality risk factors.

机构信息

Hospital Infantil de México Federico Gómez, México DF, México.

出版信息

Salud Publica Mex. 2010 Sep-Oct;52(5):391-7. doi: 10.1590/s0036-36342010000500006.

Abstract

OBJECTIVE

To assess the epidemiologic characteristics of invasive pneumococcal diseases (IPD) among a population in a pediatric hospital in Mexico City and analyze mortality-related risk factors, serotype distribution and antibiotic susceptibility related to S.pneumoniae.

MATERIAL AND METHODS

We performed a retrospective review of IPD cases at a third level pediatric hospital between 1997-2004.

RESULTS

A total of 156 patients were included. The mortality rate was 27.5% and was associated with six pneumococcal serotypes: 14, 6B, 23F, 6A, 19F and 19A. There was no relationship between mortality and antimicrobial susceptibility pattern. A total of 28.2% of isolates were resistant to penicillin and 24.6% were resistant to cefotaxime. A statistically significant relationship was observed between mortality and previous underlying disease (CI 95%; 2.5-18.3; p< 0.05) using a multivariate logistic regression model.

CONCLUSIONS

Our outcomes show that IPD mortality in our population is closely related to underlying disease and to six serotypes, five of which are included in the 7-valent pneumococcal conjugate vaccine.

摘要

目的

评估墨西哥城一家儿科医院人群中侵袭性肺炎球菌病(IPD)的流行病学特征,并分析与肺炎链球菌相关的死亡率相关危险因素、血清型分布和抗生素敏感性。

材料和方法

我们对 1997-2004 年间一家三级儿科医院的 IPD 病例进行了回顾性研究。

结果

共纳入 156 例患者。死亡率为 27.5%,与 6 种肺炎球菌血清型有关:14、6B、23F、6A、19F 和 19A。死亡率与抗菌药物敏感性模式之间没有关系。28.2%的分离株对青霉素耐药,24.6%的分离株对头孢噻肟耐药。使用多变量逻辑回归模型,我们观察到死亡率与既往基础疾病之间存在显著关系(CI95%;2.5-18.3;p<0.05)。

结论

我们的结果表明,我们人群中的 IPD 死亡率与基础疾病和 6 种血清型密切相关,其中 5 种血清型包含在 7 价肺炎球菌结合疫苗中。

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