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].
References
60.
2. Ministry of Health of Indonesia. Profil kesehatan Indonesia
tahun ZOOS. Jakarta: Ministry of Health of Indonesia;
2007.
3. Toltzis P, Blumer JL. Antibiotic resistance. In: Feigin RD,
Cherry], Demmler G, Kaplan S, editors. Texbook of pediatric
infectious diseases. Sthed. Philadelphia: WB Saunders; 2004.
p.2944·58.
4. Doern GY, Heilmann KP, Huynh HK, Rhomberg PR,
Coffman SL, Brueggemann AB. Antimicrobial resistance
among clinical isolate of Streptococcus pneumonia in the
United States during 1999􀂊ZOOO, including a comparison
of resistance rates since 1994􀂊199S. Antimicrob Agents
Chemother.2001;45,1721.9.
5. Samore MH, Magill MK, Alder se, Severina E, MorrisondeBoer
L, Lyon JL, et al. High rates of multiple antibiotic
resistance in Streptococcus pneumonia from healthy children
living in isolated rural communities: association with
cephalosporin use and intrafamilial transmission. Pediatrics.
200 I; 108,856·64.
6. Levin AS, Sessegolo JF, Teixeira LM, Barone AA. Factors
associated with penicillin􀃆nonsusceptible pneumococcal
infections in Brazil. Braz J Med Bioi Res. 2003 ;36:807􀃇1 3.
7. Huang SS, F inkelstein JA, Rifas􀃆Shiman SL, Kleinman
K, Platt R. Community􀃆level predictors of pneumococcal
carriage and resistance in young children. Am J EpidemioL
2004; 159,645·54.
8. Ostapchuk M, Roberts OM, Haddy R. eommunity􀂇acquired
pneumonia in infants and children. Am Fam Physician.
2004; 70,899·90S.
9. Baqui HA, Rahman M, Zaman K, El Afifeen S, Chowdhury
HR, Begum G, et al. A population􀃆based study of hospital
admission incidence rate and bacterial aetiology of acute
lower respiratory infection in children aged less than five
years in Bangladesh.) Health Popul Nutr. 2007;25,179.88.
10. Guillemot D, Carbon C, Balkau B, Geslin P, Lecoeur H,
Vauzelle-Kervroedan F, et at. Low dosage and long treatment duration of 13􀂊lactam: risk factors of carriage of penicillin􀂊
resistant Streptococcus pneumonia. JAMA. 1998;279:365􀂈9.
1 1 . Karpanoja P, Nyberg ST, Bergman M, Voipio T, Paakkari
P, Huovinen P, et aL Connection between trimethoprim􀃆
sulfamethoxazole use and resistance in Streptococcus
pneumoniae, Haemophilus inf/uen,zae, and Moraxella catarrhafis.
Antimicrob Agents Chemother. 2008;SZ:Z480􀃆S.
12. Struelens MJ. The epidemiology of antimicrobial resistance in
hospital acquired infections: problems and possible solutions.
BM). 1998;31 H52-4.
13. Alanis AJ. Resistance to antibiotics: are we in the post􀃆
antibiotics era? Arch Med Res. 200S;36:697􀃉70S.
14. Clavo􀃆Sanchez AJ, Giron􀃇Gonzales JA, Lopez􀃆Prieto
0, eanueto􀃆Quintero J, Sanchez-Porto A, Vergara􀃆
Campos A, et aL Multivariate analysis of risk factors for
infection due to penicillin􀂊resistant and multidrug􀂉resistant
SLrepLococrus pneumoniae: a multicenter study. Clin Infec Dis.
1997;24,1052-9.
IS. Kellner JO, Jones LF. ScrepcococC1LS pneumoniae carriage in
children attending 59 Canadian child care centers. Arch
Pediatr Adolesc Med. 1999; 153,495·502.
16. Agostoni C, Braegger C, Oecsi T, Kolacek S, Koletzko B,
Michaelsen KF, et al. Breast􀃈feeding: a commentary by the
ESPGHAN Committee on Nutrition.] Pediatr Gastroenterol
Nutr.2009;49,1l2·25.
17. Bachrach VR, Schwarz E, Bachrach LR. Breastfeeding and
the risk of hospitalization for respiratory disease in infancy: a
meta.analysis. Arch Pediatr Adoles Med. 2003; 15N3 7-43.
IS. Scott )AG, Brooks WA, Peiris IS, Holtzman D, Mulholland
EK. Pneumonia research to reduce childhood mortality
in the developing world. Review series. J Clin Invest.
200S;llS,1291·300.
19. David MZ, Daum RS. Community-associated methidllin􀃆
resistant Staphylococcus aureus: epidemiology and clinical
consequences of an emerging epidemic. Clin Microbiol Rev.
2010;23,616·87.
20. Leal AL, Castaneda E. Antibiotic susceptibility of Streptococcus
pneumoniae colonizing the nasopharynx of Colombian
children with pneumonia. Pan Am ] Public Health.
1997;2,253·9.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2016-09-07
Published 2012-10-31
