Abstract

GRENON, Sandra L. et al. Invasive pneumococcal disease (IPD) in children: five years of surveillance of resistance to penicillin in Misiones, Argentina. Rev. cienc. tecnol. [online]. 2009, n.12, pp.34-40. ISSN 1851-7587.

This work presents the results of the surveillance (2004-2008) for b-lactam resistant Streptococcus pneumoniae (Spn) in children with IPD (1 month to 14 years old) admitted at the Paediatric Hospital "Dr. Fernando Barreyro". One isolation for patient was considered. Minimal inhibitory concentration for penicillin (MICpen) and cefotaxime (MICctx) was performed according to the Clinical and Laboratory Standards Institute 2009. The number of cases diagnosed amounted 129, with peaks in Winter and Spring. By 2008 a significant decrease (6,5 cases/year, r2 = 0,85) was observed. Fifty two percent were younger than 2 years old, 57.4 % being males. The isolates were from blood (79, 58.1 %), pleural (32, 23.9 %), cerebrospinal (13, 9.7 %), articular (4, 3.1 %) and others fluids (4, 3.1 %). Pneumonias were the most frequent (88 cases, 65 %, 34 of whom had empyema and 52 bacteraemia), followed bymeningitis (23, 18 %), sepsis (9, 7 %) and others. Ninety-five strains (73 %) had CIMpen ≤ 0.06 mg/ml, 21 (16,3 %) between 0.12 - 1 mg/ml and 11 (8.5 %) of 2 mg/ml. The highest levels were detected in youngest children, no isolation had MICpen > 2 mg/ml or MICctx > 0,5 mg/ml. A decrease in levels of resistance to penicillin by 2008 was observed. To maintain an active surveillance in the region is a clear need, so as to guide therapeutic policy and to control the spread of b-lactam resistant Spn.

Keywords : Streptococcus pneumoniae; B-lactam resistance; Surveillance.

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