PREDICTIVE FACTORS FOR INVASIVE DISEASE DUE TO PENICILLIN-RESISTANT STREPTOCOCCUS-PNEUMONIAE - A POPULATION-BASED STUDY

被引:183
作者
NAVA, JM
BELLA, F
GARAU, J
LITE, J
MORERA, MA
MARTI, C
FONTANALS, D
FONT, B
PINEDA, V
URIZ, S
DEULOFEU, F
CALDERON, A
DURAN, P
GRAU, M
AGUDO, A
机构
[1] HOSP TERRASSA, E-08221 BARCELONA, SPAIN
[2] HOSP GEN GRANOLLERS, E-08221 BARCELONA, SPAIN
[3] HOSP SABADELL, E-08221 BARCELONA, SPAIN
[4] HOSP MOLLET, E-08221 BARCELONA, SPAIN
[5] IREC, E-08221 BARCELONA, SPAIN
关键词
D O I
10.1093/clinids/19.5.884
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
A prospective population-based study was carried out to determine predictive factors associated with penicillin-resistant pneumococcal invasive disease. A total of 374 patients (250 males and 124 females; mean age, 50.3 +/- 27 years) with invasive pneumococcal infection were admitted to one of the five hospitals in El Valles County (an industrial area with 800,000 inhabitants in the province of Barcelona, Spain) over a period of 5 years. Of the 374 episodes, 21 (5.6%) were due to highly penicillin-resistant pneumococci and 67 (17.9%) to intermediately penicillin-resistant pneumococci. Multivariate analysis showed a statistically significant association between infection with intermediately penicillin-resistant pneumococci and an age of 0-4 years (odds ratio [OR] = 5.3; 95% confidence interval [CI] = 2.2-12.6), the presence of an immunosuppressive underlying disease (OR = 3.0; 95% CI = 1.5-6.0), and the previous use of beta-lactam antibiotics (OR = 2.1; 95% CI = 1.0-4.5). Infection with highly penicillin-resistant pneumococci was associated only with the previous use of beta-lactam antibiotics (OR = 5.9; 95% CI = 2.2-15.8). Highly resistant strains were of serotypes 6, 9, 14, 15, 19, and 23, of which all but serotypes 9 and 15 are included in the newly formulated conjugated vaccine.
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页码:884 / 890
页数:7
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