Clinical features of inhaled and blood-borne Staphylococcus aureus pneumonia and analysis of antibiotic resistance of the pathogen in children

ZHANG Guang-Li; LIU Ru; ZHANG Hui; LI Ying; ZHANG Dong-Wei; LI Jun-Qi; ZHANG Si-Ying; ZHU Jun; LUO Zheng-Xiu

doi:10.7499/j.issn.1008-8830.2014.10.004

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Chinese Journal of Contemporary Pediatrics ›› 2014, Vol. 16 ›› Issue (10) : 979-983. DOI: 10.7499/j.issn.1008-8830.2014.10.004

TOPIC OF WORLD PNEUMONIA DAY

Clinical features of inhaled and blood-borne Staphylococcus aureus pneumonia and analysis of antibiotic resistance of the pathogen in children

ZHANG Guang-Li, LIU Ru, ZHANG Hui, LI Ying, ZHANG Dong-Wei, LI Jun-Qi, ZHANG Si-Ying, ZHU Jun, LUO Zheng-Xiu

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Abstract

Objective To compare the clinical manifestations between inhaled and blood-borne Staphylococcus aureus pneumonia (SAP) and the antibiotic resistance between the isolates of inhaled and blood-borne Staphylococcus aureus. Methods The clinical data of 44 pediatric SAP cases in the Children's Hospital, Chongqing Medical University from January 2008 to December 2013 were retrospectively analyzed. Twenty-four cases were identified as inhaled SAP, and 20 cases as blood-borne SAP. Results Inhaled SAP was more common in children younger than 3 years of age, while blood-borne SAP was more prevalent in children older than 6 years of age. Patients with inhaled SAP had significantly higher incidence rates of cough, wheeze, moist rales, dyspnea and empyema than those with blood-borne SAP (P<0.05). The patients with blood-borne SAP were more vulnerable to severe fever, unconsciousness, dysfunction of liver and kidney, pyogenic osteomyelitis, septic arthritis, sepsis, and abscess of skin and soft tissues (P<0.05). Inhaled SAP isolates had significantly higher rates of resistance to amoxicillin/clavulanic acid, oxacillin, and cefoxitin than blood-borne SAP isolates (P<0.05), while the latter had a higher rate of resistance to cotrimoxazole (P<0.05). Conclusions Inhaled SAP often occurs in children younger than 3 years of age, and the respiratory manifestations are commonly seen. Blood-borne SAP often occurs in children older than 6 years of age, with the infectious-toxic symptoms that result in multiple organ infection and dysfunction. The isolates of inhaled and blood-borne SAP have different antibiograms.

Key words

Pneumonia / Staphylococcus aureus / Antibiotic resistance / Child

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ZHANG Guang-Li, LIU Ru, ZHANG Hui, LI Ying, ZHANG Dong-Wei, LI Jun-Qi, ZHANG Si-Ying, ZHU Jun, LUO Zheng-Xiu. Clinical features of inhaled and blood-borne Staphylococcus aureus pneumonia and analysis of antibiotic resistance of the pathogen in children[J]. Chinese Journal of Contemporary Pediatrics. 2014, 16(10): 979-983 https://doi.org/10.7499/j.issn.1008-8830.2014.10.004

References

[1] Newman MJ, Frimpong E, Donkor ES, et al. Resistance toantimicrobial drugs in Ghana[J]. Infect Drug Resist, 2011, 4:215-220.
[2] Seil JT, Webster TJ. Antimicrobial applications ofnanotechnology: methods and literature[J]. Int J Nanomedicine,2012, 7: 2767-2781.
[3] 李六亿, 刘玉树, 巩玉秀, 等. 医院感染管理学[M]. 北京: 北京大学医学出版社, 2012: 84-89.
[4] 詹松, 程瑞新, 耿道颖. 急危重症影像诊断学[M]. 北京: 清华大学出版社, 2012: 92.
[5] 张树基, 罗明绮. 内科急症诊断与治疗[M]. 北京: 中国科学技术出版社, 2010: 81-88.
[6] 余森阳, 孙君宝. 呼吸内科临床诊治精要[M]. 北京: 中国协和医科大学出版社, 2011: 238-239.
[7] 胡亚美, 江载芳. 诸福棠实用儿科学[M]. 第7 版. 北京：人民卫生出版社, 2002: 855-861.
[8] Deleo FR, Otto M, Kreiswirth BN, et al. Community-associatedmeticillin-resistant Staphylococcus aureus[J]. Lancet, 2010,375(9725): 1557-1568.
[9] 施毅. 肺部革兰阳性球菌感染的诊治进展[J]. 解放军医学杂志, 2010, 35(7): 763-768.
[10] Sattler CA, Correa AG. Coagulase-positive staphylococcalinfections (staphylococcus aureus)[M]//Feigin RD, Cherry JD,Demmler GJ, et al. Textbook of Pediatric Infectious Diseases5th ed(Vol.1). Philadelphia, PA: Saunders, 2004: 1099-1129.
[11] 中华医学会儿科学分会呼吸学组, 《中华儿科杂志》编辑委员会. 儿童社区获得性肺炎管理指南(2013 修订)( 下) [J]. 中华儿科杂志, 2013, 51(11): 856-862.
[12] 《中华儿科杂志》编辑委员会, 中华医学会儿科学分会呼吸学组, 中华医学会儿科学分会急救学组, 等. 儿童医院获得性肺炎管理方案(2010 版)[J]. 中华儿科杂志, 2011, 49(2):106-115.
[13] 林雪峰, 李敏, 李春碧, 等. 儿童金黄色葡萄球菌肺炎52 例临床分析 [J]. 小儿急救医学, 2003, 10(5): 296-298.
[14] 王群, 高燕, 欧维琳, 等. 儿童感染金黄色葡萄球菌的临床特点与耐药状况[J]. 华夏医学, 2010, 23(2): 123-126.
[15] Peacock SJ, Justice A, Griffiths D, et al. Deteminants ofacquisition and carriage of Staphylococcus aureus in infancy[J].J Clin Microbiol, 2003, 41(12): 5718-5725.
[16] Bae S, Yu JY, Lee S, et al. Nasal colonization by four potentialrespiratory bacteria in healthy children attending kindergarten orelementary school in Seoul, Korea [J]. J Med Microbiol, 2012,61(Pt 5): 678-685.
[17] Pathak A, Marothi Y, Iyer RV, et al. Nasal carriage andantimicrobial susceptibility of Staphylococcus aureus in healthypreschool children in Ujjain, India [J]. BMC Pediatr, 2010, 10:100.
[18] Chen CJ, Hsu KH, Lin TY, et al. Factors associated with nasalcolonization of methicillin-resistant Staphylococcus aureusamong healthy children in Taiwan [J]. J Clin Microbiol, 2011,49(1): 131-137.
[19] 沈晓明, 王卫平. 儿科学[M]. 第7 版. 北京: 人民卫生出版社,2010: 259.
[20] 艾赛提. 金黄色葡萄球菌肺炎30 例X 线分析[J]. 中国医学创新, 2009, 6(25): 158.
[21] Havaei SA, Moghim S, Bardebari AM, et al. The comparison ofStaphylococcus aureus types 5 and 8 with respect to methicillinresistance in patients admitted to AI-Zahra Hospital by PCR [J].Adv Biomed Res, 2013, 2: 13.
[22] Liarruii Li, Fisher JF, Mobashery S. Molecular basis andphenotype of methicillin resistance in Staphylococcus aureusand insights into new beta-lactams that meet the challenge [J].Antimicrob Agents Chemother, 2009, 53(10): 4051-4063.