RESUMO
OBJECTIVE: The purpose of this study was to study the epidemiology of invasive childhood pneumococcal infection in our hospital. PATIENTS AND METHODS: The records of all children attending our hospital from whom Streptococcus pneumoniae was isolated from the blood or CSF were reviewed. Serotyping and MIC were performed at C.N.M.V.S. (Majadahonda). RESULTS: Seventy-one pneumococci were isolated in 70 patients. The annual incidence increased from 0.14% to 0.40%. The clinical entities were: bacteremia without focus (45%), pneumonia (29.6%), meningitis (12.7%), cellulitis (5.6%), mastoiditis (5.6%) and endocarditis (1.4%). The age of 72% of the patients was less than 3 years. In 26.8% of the cases, the patient had an underlying disease and/or was previously hospitalized. The antibiotic susceptibility pattern was: penicillin (MIC < or = 0.06 microgram/ml) 45.7%, cefotaxime (MIC < or = 0.5 microgram/ml) 82.8% and erythromycin (MIC < or = 0.5 microgram/ml) 70%. Penicillin resistance of the isolated pneumococci was more often present in the group with risk factors than in those without such risk factors (p < 0.05). There were 13 different serotypes, the most prevalent were 6 (23%), 19 (17%), 14 (14%) and 23 (12%) and the most frequently penicillin-resistant (Resistant N(o)/Total N(o) were: 6 (15/15), 9 (4/4), 14 (8/9) and 23 (6/8). CONCLUSIONS: Streptococcus pneumoniae is a common cause of invasive infections in children in our hospital. There was a high prevalence of serotype 6 (penicillin-resistant) as compared to in adults where serotype 3 (penicillin-susceptible) is the most prevalent. A higher rate of antibiotic resistant strains associated with risk factors (underlying disease or nosocomial acquisition), probably related to prior antibiotic use, was observed.
Assuntos
Infecções Estreptocócicas/epidemiologia , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Masculino , Estudos Retrospectivos , Infecções Estreptocócicas/tratamento farmacológicoAssuntos
Antibacterianos/uso terapêutico , Ceftriaxona/uso terapêutico , Resistência Microbiana a Medicamentos , Meningite Pneumocócica/tratamento farmacológico , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Ceftriaxona/administração & dosagem , Quimioterapia Combinada , Humanos , Lactente , Injeções Intravenosas , Masculino , EsteroidesAssuntos
Brucella abortus/isolamento & purificação , Brucelose/epidemiologia , Adulto , Idoso , Animais , Brucelose/microbiologia , Bovinos/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/epidemiologia , Doenças Profissionais/microbiologia , Espanha/epidemiologiaRESUMO
The main clinical manifestations of 42 cases of Q fever occurring in an outbreak in Valmaseda, Spain during March, April and May 1982 are described in this paper. The benign character of the acute disease is emphasized. Further epidemiologic studies must be done to determine the incidence of Q fever in the Basque country.
