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Article in Japanese

Clinical analysis of pediatric bacterial bronchopulmonary infection in which β-lactam-resistant strains were isolated from sputum

Tadashi HOSHINO1), Naruhiko ISHIWADA2), Chie FUKASAWA1), Fumie NAGAI3), Katsuaki ABE3), Jiro AIZAWA4), Nobuyasu ISHIKAWA4), Yoshiko HONDA2), Junko TANAKA2), Haruka HISHIKI2), Yoichi KONO2)

We retrospectively analyzed 289 cases of pediatric bacterial bronchitis/pneumonia to make clear the risk factor of β-lactamase-non-producing ampicillin-resistant Haemophilus influenzae, β-lactamase-producing amoxicillin-clavulanic acid-resistant H. influenzae and penicillin-resistant Streptococcus pneumoniae infection. Correlation between the rate of β-lactam-resistant strain and five factors; 1) severity of pneumonia classified by scoring system presented in guideline for management of respiratory infectious disease in children in Japan 2007, 2) duration of fever and cough, 3) premedication of antibiotics, 4) complication of otitis media and 5) group nursing, were evaluated. Statistical analysis revealed a high rate of resistant strain in the patients with premedication or otitis media. However, in these patients, the resistance rate was only about 50%. Hence, it seemed to be difficult to select the patient infected with a resistant strain by such factors. Results of this study indicate the significance of identification of causative bacteria for prompt usage of antimicrobial agents.

1) Division of Infectious Diseases, Chiba Children's Hospital
2) Department of Pediatrics, Chiba University Graduate School of Medicine
3) Department of Pediatrics, Chiba Municipal Kaihin Hospital
4) Department of Pediatrics, Chiba Municipal Aoba Hospital

Key words
Received April 25, 2011
Accepted June 13, 2011

23 (3):251─256,2011