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  • Title: Risk factors for penicillin-resistant systemic pneumococcal infections in children.
    Author: Doone JL, Klespies SL, Sabella C.
    Journal: Clin Pediatr (Phila); 1997 Apr; 36(4):187-91. PubMed ID: 9114988.
    Abstract:
    The purpose of this study was to identify risk factors that may differentiate children who develop systemic infections with resistant strains of Streptococcus pneumoniae from those who develop penicillin-susceptible pneumococcal infections. A retrospective case-controlled study was performed of all patients with positive blood and/or cerebrospinal fluid isolates for S. pneumoniae over a 13 1/2-month period. Patients with penicillin-susceptible strains of S. pneumoniae were compared with those with penicillin-resistant infections in terms of age, race, gender, diagnosis, underlying conditions, antibiotic therapy within 1 month prior to systemic infection, treatment, and outcome. Sixty-nine patients with systemic pneumococcal infections were identified over the study period. Nine (13%) of these patients had infection with a penicillin-resistant isolate. Six of these patients were infected with a relatively resistant strain (MIC 0.1-1.0 microgram/mL) while three were infected with a fully resistant strain (MIC > or = 2.0 micrograms/mL). There was no difference between the two groups in terms of age, race, gender, underlying diagnosis, treatment, or outcome. Sixty-seven percent of the patients who developed a penicillin-resistant pneumococcal infection had received antibiotics in the month prior to systemic illness versus 4% of those infected with a penicillin-susceptible strain (P < 0.0000097). In conclusion, when compared with children who develop systemic infection with a penicillin-susceptible strain of S. pneumoniae, children who develop infection with a penicillin-resistant strain are significantly more likely to have received antibiotics within 1 month prior to their illness.
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