Community acquired pneumonia among pediatric outpatients in Salvador, Northeast Brazil, with emphasis on the role of pneumococcus



Título del documento: Community acquired pneumonia among pediatric outpatients in Salvador, Northeast Brazil, with emphasis on the role of pneumococcus
Revista: The brazilian journal of infectious diseases
Base de datos: PERIÓDICA
Número de sistema: 000290672
ISSN: 1413-8670
Autores: 1
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Instituciones: 1Universidade Federal da Bahia, Departamento de Pediatria, Salvador, Bahia. Brasil
2Universidade Federal da Bahia, Medicina Interna, Salvador, Bahia. Brasil
3Universidade Federal da Bahia, Faculdade de Medicina, Salvador, Bahia. Brasil
4Instituto Adolfo Lutz, Secao de Bacteriologia, Sao Paulo. Brasil
5Hospital Alianca, Salvador, Bahia. Brasil
6Laboratorio Central da Bahia, Salvador, Bahia. Brasil
7Organización Panamericana de la Salud, Washington, Distrito de Columbia. Estados Unidos de América
Año:
Periodo: Feb
Volumen: 5
Número: 1
Paginación: 13-20
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Caso clínico, analítico
Resumen en inglés Pneumonia is one of the leading causes of hospitalization and death among children in developing countries, and mortality due to pneumonia has been associated with S. pneumoniae infection. This investigation was designed to describe the antimicrobial susceptibility and serotype patterns of pneumococcal strains recovered from the blood of children with community-acquired pneumonia (CAP) and to assess the clinical findings of pneumococcal bacteremic patients with pneumonia. In a 26 month prospective study, blood cultures were obtained as often as possible from children (<16 years of age) diagnosed with CAP in two emergency rooms. Antimicrobial drug susceptibility tests and serotyping were performed when pneumococcus was identified. We studied 3,431 cases and cultured blood samples from 65.5% of those. Pneumococcus was recovered from 0.8% of the blood samples. The differences in age, somnolence, wheezing and hospitalization among children with and without pneumococcal bacteremia were statistically significant. Pneumococcal bacteremia was age-related (mean 1.63 ± 1.55; median 0.92) and associated with somnolence and hospitalization among children with CAP. One strain was recovered from pleural fluid. Penicillin resistance was detected in 21.0% (4/19) of the strains at an intermediate level, whereas 63.0% of the strains were resistant to trimethoprim-sulfamethoxazole. The most common serotypes were 14 and 6B, and these serotypes included the resistant strains. Eight of our 18 isolates from blood were of types included in the heptavalent conjugate pneumococcal vaccine, recently licensed in the USA
Disciplinas: Medicina
Palabras clave: Diagnóstico,
Neumología,
Pediatría,
Streptococcus pneumoniae,
Resistencia antimicrobiana,
Serotipos,
Hemocultivo,
Neumonía,
Niños
Keyword: Medicine,
Diagnosis,
Pediatrics,
Pneumology,
Streptococcus pneumoniae,
Antimicrobial resistance,
Serotypes,
Blood culture,
Pneumonia,
Children
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