Multivariate Analysis of Risk Factors for Infection Due to Penicillin‐Resistant and Multidrug‐ResistantStreptococcus pneumoniae: A Multicenter Study

Abstract

Pneumococcal disease was studied prospectively to determine the risk factors associated with resistance to penicillin and other antibiotics. One hundred twelve clinically significant pneumococcal isolates were recovered from 95 patients. Approximately one-half (49.47%) of the cases were due to penicillin-resistant strains. Multivariate analysis showed that previous use of beta-lactam antibiotics (odds ratio [OR], 2.81; 95% confidence interval [CI], 0.95-8.27), alcoholism (OR, 5.22; 95% CI, 1.43-19.01), and noninvasive disease (OR, 4.53; 95% CI, 1.54-13.34) were associated with penicillin resistance, whereas intravenous drug use (OR, 0.14; 95% CI, 0.03-0.74) was not. Statistical analyses of the variables associated with resistance to multiple antibiotics detected age of younger than 5 years (OR, 16.79; 95% CI, 1.60-176.34) or of 65 years or older (OR, 4.33; 95% CI, 1.42-13.21) and previous use of beta-lactam antibiotics by patients with noninvasive disease (OR, 7.92; 95% CI, 1.84-34.06) as parameters associated with increased risk. We conclude that multivariate analysis provides clues for empirical therapy for pneumococcal infection.

Bacteria, antibiotics and COPD

“…Resistance to macrolide antibiotics, including the newer agents clarithromycin and azithromycin, was present in 48% of strains with high penicillin resistance. Risk factors for multidrug resistant S. pneumoniae include prior antibiotic use, extremes of age and hospitalization [79]. In two other recent large surveillance studies [80,81] beta-lactamase production was found in 33.4% of H. influenzae and 95% of M. catarrhalis.…”

Antimicrobial Resistance of Streptococcus pneumoniae Recovered from Outpatients with Respiratory Tract Infections in Germany from 1998 to 1999: Results of a National Surveillance Study

“…One remarkable finding of the present investigation is that resistance rates showed pronounced variations between geographic regions and study centers within Germany. Major differences in beta-lactam resistance between children and adults have been reported in many other countries, and young age has been shown to be a risk factor for beta-lactam-resistant pneumococcal infection (2). In Germany only slight differences in beta-lactam resistance rates between children and adults were recorded.…”

Non-Antibiotic Treatment for Pediatric Outpatients With Common Cold Inhibits the Emergence of Drug Resistant Pneumococci

“…Children with sibling(s) were 66.7% 16) . There were 79.2% 19) patients who had taken beta -lactams and 20.8% 5) patients had taken macrolides within the past 3 months before the test. The mean term of antibiotic medication was 5 days.…”

“…Worldwide, risk factors for the carriage of resistant S. pneumoniae have been well investigated in the last couple of decades [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] and those studies reported that the most influencing factor was the previous use of antibiotics. Unnecessary use of antibiotics had been thought to cause this emergence of antibiotic resistant S. pneumoniae.…”