埃塞俄比亚西北部贡德尔大学医院儿科门诊患者中肺炎链球菌的鼻咽携带率及抗菌药物敏感性模式。
Nasopharyngeal carriage and antimicrobial susceptibility pattern of Streptococcus pneumoniae among pediatric outpatients at Gondar University Hospital, North West Ethiopia.
机构信息
Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
Pediatr Neonatol. 2013 Oct;54(5):315-21. doi: 10.1016/j.pedneo.2013.03.017. Epub 2013 May 14.
BACKGROUND
Pneumonia caused by Streptococcus pneumoniae is the leading cause of death among children in Ethiopia. S. pneumoniae nasopharyngeal carriage can result in endogenous infections and bacterial spread in the community. S. pneumoniae drug resistance is rapidly increasing worldwide. The aim of the study was to assess the nasopharyngeal carriage and antimicrobial susceptibility pattern of S. pneumoniae among pediatric outpatients.
METHODS
A cross-sectional study was conducted on children aged ≤10 years from February to May of 2012. Data on potential risk factors were gathered using an interview-based questionnaire. Nasopharyngeal specimens were collected with a sterile plastic cotton tip swab. Bacteria were characterized by colony appearance, Gram staining, and optochin susceptibility and bile solubility tests. An antimicrobial susceptibility test was performed using the disk diffusion method. A logistic regression analysis was used to examine the possible risk factors. All tests with p value less than 0.05 were considered statistically significant.
RESULTS
Of the 234 children screened, 41.03% carried S. pneumoniae. Age-related downward trend for S. pneumoniae carriages (50.9% in <3-year-olds, 40.7% in 3- to 5-year-olds, 40.0% in 5- to <8-year-olds, and 33.3% in 8- to 10-year-olds) were observed. Children living with siblings < 5 years old (p = 0.003) and in a house having one room (p = 0.004) were associated with higher S. pneumoniae carriage. S. pneumoniae showed 33.2% resistance to erythromycin and tetracycline, 29.2% to cotrimoxazole, 14.6% to chloramphenicol and ciprofloxacin, and 10.4% to penicillin.
CONCLUSION
The S. pneumoniae carriage rate was higher among younger children. High antimicrobial resistance of S. pneumoniae against erythromycin, tetracycline, and cotrimoxazole was observed. Being in the young age group and living with younger children are risk factors for pneumococcal carriage.
背景
肺炎链球菌引起的肺炎是埃塞俄比亚儿童死亡的主要原因。肺炎链球菌鼻咽携带可导致内源性感染和社区内细菌传播。肺炎链球菌的药物耐药性在全球范围内迅速增加。本研究旨在评估儿科门诊患者中肺炎链球菌的鼻咽携带情况和抗生素敏感性模式。
方法
2012 年 2 月至 5 月，对年龄≤10 岁的儿童进行了横断面研究。使用基于访谈的问卷收集潜在危险因素数据。使用无菌塑料棉签采集鼻咽标本。通过菌落外观、革兰氏染色、奥普汀敏感性和胆汁溶解性试验对细菌进行特征描述。使用纸片扩散法进行抗生素敏感性试验。使用逻辑回归分析检查可能的危险因素。所有 p 值小于 0.05 的测试均被认为具有统计学意义。
结果
在所筛选的 234 名儿童中，41.03%携带肺炎链球菌。肺炎链球菌携带率呈年龄相关的下降趋势（<3 岁儿童为 50.9%，3-5 岁儿童为 40.7%，5-<8 岁儿童为 40.0%，8-10 岁儿童为 33.3%）。与肺炎链球菌携带相关的因素包括与年龄较小的兄弟姐妹同住（p=0.003）和居住在一个房间的家庭（p=0.004）。肺炎链球菌对红霉素和四环素的耐药率为 33.2%，对复方磺胺甲噁唑的耐药率为 29.2%，对氯霉素和环丙沙星的耐药率为 14.6%，对青霉素的耐药率为 10.4%。
结论
年龄较小的儿童肺炎链球菌携带率较高。肺炎链球菌对红霉素、四环素和复方磺胺甲噁唑的抗生素耐药率较高。年龄较小和与年幼儿童同住是肺炎链球菌携带的危险因素。
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