Zenni M K, Cheatham S H, Thompson J M, Reed G W, Batson A B, Palmer P S, Holland K L, Edwards K M
Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
J Pediatr. 1995 Oct;127(4):533-7. doi: 10.1016/s0022-3476(95)70108-7.
To determine the nasopharyngeal colonization rate of penicillin-susceptible and penicillin-resistant strains of Streptococcus pneumoniae in young children, and to assess its relationship with the incidence of otitis media.
Observational study in 215 children younger than 6 years of age who received care in the Vanderbilt Vaccine Clinic from September 1, 1992, to August 31, 1993.
Of 842 nasopharyngeal cultures obtained, results for 44% of the cultures were positive for S. pneumoniae; 73% of the isolates were serotypes 6, 14, 19, or 23. Younger children had significantly higher rates of pneumococcal colonization than older children, with a peak at 1 year of age. By microdilution susceptibility testing, 37% of the cultures with positive results were intermediately or highly resistant to penicillin. Significantly more serotype 19 and 23 isolates were penicillin resistant than organisms of other serotypes. Children younger than 2 years of age had a twofold higher percentage of resistant isolates than those older than 2 years of age. A significant association was noted between nasopharyngeal carriage of S. pneumoniae and acute otitis media (p = 0.0002); however, the incidence of acute otitis media did not differ significantly between children colonized with penicillin-susceptible or penicillin-resistant strains. Unresolved otitis media was diagnosed more often in children who were colonized with resistant organisms than in children colonized with susceptible strains (p = 0.04).
There was a high rate of nasopharyngeal carriage of penicillin-resistant S. pneumoniae in this population of young children. Nasopharyngeal colonization was associated with an increased incidence of acute otitis media, and penicillin resistance was associated with an increased incidence of unresolved otitis media.
确定幼儿中青霉素敏感和耐药肺炎链球菌的鼻咽部定植率，并评估其与中耳炎发病率的关系。
对1992年9月1日至1993年8月31日在范德比尔特疫苗诊所接受治疗的215名6岁以下儿童进行观察性研究。
在获得的842份鼻咽培养物中，44%的培养物肺炎链球菌检测结果呈阳性；73%的分离株为6、14、19或23血清型。年幼儿童的肺炎球菌定植率明显高于年长儿童，在1岁时达到峰值。通过微量稀释药敏试验，37%检测结果呈阳性的培养物对青霉素中度或高度耐药。19型和23型血清型分离株的青霉素耐药率明显高于其他血清型菌株。2岁以下儿童的耐药分离株百分比比2岁以上儿童高出两倍。肺炎链球菌的鼻咽部携带与急性中耳炎之间存在显著关联（p = 0.0002）；然而，青霉素敏感或耐药菌株定植的儿童中急性中耳炎的发病率没有显著差异。与敏感菌株定植的儿童相比，耐药菌株定植的儿童中未治愈中耳炎的诊断更为常见（p = 0.04）。
该幼儿群体中青霉素耐药肺炎链球菌的鼻咽部携带率很高。鼻咽部定植与急性中耳炎发病率增加有关，而青霉素耐药与未治愈中耳炎发病率增加有关。
