Risk factors for cefotaxime resistance in children with pneumonia
Abstract
Background Pneumonia is a health problem in developing
countries, often caused by bacterial agents. The 'Widespread
use of cefotaxime, a thirdô€’generation of cephalosporin, may lead
to increased incidence of resistance to this antibiotic. Several
studies have reported on risk factors associated v.ith resistance
to cefotaxime.
Objective To identify risk factors for cefotaxime resistance in
children 'With pneumonia.
Methods We performed a caseô€’control study at Sanglah Hospital
between January 2006ô€’December 2010. The case group included
children with blood cultureô€’positive pneumonia and resistance
to cefotaxime by sensitivity test. The control group was selected
from the same population as the case group, but the bacteria
isolated from these subjects were sensitive to cefotaxime. We
tested the folloMng risk factors for resistance to cefotaxime:
age :53 years, microorganism species, history of antimicrobial
use, and history of hospitalization within the prior 3 months.
Chi square test and logistic regression analysis were performed
to determine any associations between the four potential risk
factors and resistance to cefotaxime. A P<0.05 was considered
to be statistically significant.
Results Univariate analysis showed that the risk factors for
resistance to cefotaxime were history of antimicrobial use in the
prior 3 months (OR 2.79; 95%CI 1.40 to 5.55; Pô€“O.OOI) and
history of hospitalization Mthin the prior 3 months (OR 5.57;
95%CI 1.95 to 15.87; P=<O.OOOl). By multivariate analysis,
risk factors associated Mth resistance to cefotaxime were history
of antimicrobial use in the prior 3 months (OR 2.4; 95%CI 1.18
to 4.86; P=0.015), history of hospitalization within the prior 3
months (OR 4.7; 95%CI 1.62 to 13.85; Pô€“0.004), and history
of breast feeding for less than 2 months (OR 2.3; 95%CI 1.0 to
5.4; Pô€“0.042).
Conclusion History of antimicrobial use and history of
hospitalization within the prior 3 monthsweresignificantriskÂ
factors for resistance to cefotaxime in children Mth pneumonia.
[Paediatr Indanes. 2012;52:255-9].
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Accepted 2016-09-07
Published 2012-10-31
