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Penicillin-resistant systemic pneumococcal infections in children: a retrospective case-control study
T Q Tan1, E O Mason, S L Kaplan
1Department of Pediatrics, Baylor College of Medicine, Houston, TX.
Pediatrics
|December 1, 1993
Summary
Recent antibiotic use is a key risk factor for penicillin-resistant Streptococcus pneumoniae infections in children. This finding highlights the importance of judicious antibiotic stewardship to combat antimicrobial resistance.
Area of Science:
- Pediatric Infectious Diseases
- Antimicrobial Resistance
- Clinical Microbiology
Background:
- Systemic infections caused by Streptococcus pneumoniae (pneumococcus) are a significant concern in pediatric populations.
- Penicillin resistance in S. pneumoniae poses a growing challenge to effective treatment.
- Identifying risk factors for resistant infections is crucial for guiding clinical management and public health strategies.
Purpose of the Study:
- To investigate potential risk factors differentiating children with systemic penicillin-resistant S. pneumoniae infections from those with susceptible S. pneumoniae infections.
- To determine if prior antibiotic exposure is associated with the development of penicillin-resistant pneumococcal infections in children.
Main Methods:
- Retrospective case-control study conducted at a large children's hospital.
- Cases comprised 43 children with systemic penicillin-resistant S. pneumoniae infections.
- Controls (n=66) were matched for age and date of infection, with susceptible S. pneumoniae isolates.
Main Results:
- Thirty-seven cases (86%) had relatively resistant isolates (MIC 0.125-1.0 µg/mL), and six (15%) had fully resistant isolates (MIC 2.0-8.0 µg/mL).
- Children with penicillin-resistant S. pneumoniae infections were significantly more likely to have received antibiotics in the month preceding their infection (71% vs. 39%, P = .02).
- No significant differences were observed in underlying conditions between cases and controls.
Conclusions:
- Antibiotic use within the month prior to infection emerged as the sole identified risk factor for systemic penicillin-resistant pneumococcal infections in children.
- These findings underscore the critical role of antibiotic stewardship in preventing the emergence and spread of antimicrobial resistance in pediatric pathogens.
- Further research may explore specific antibiotic classes and treatment durations contributing to resistance.