Risk factors for acquisition of levofloxacin-resistant Streptococcus pneumoniae: a case-control study.
A case-control study was conducted to identify the risk factors associated with levofloxacin-resistant Streptococcus pneumoniae (LRSP) colonization or infection. Twenty-seven case patients (patients with LRSP) were compared with 54 controls (patients with levofloxacin-susceptible S. pneumoniae). Risk factors that were significantly associated with LRSP colonization or infection, according to univariate analysis, included an older age (median age, 75 years for case patients versus 72.5 years for controls), residence in a nursing home (odds ratio [OR], 7.2), history of recent (OR, 4.6) and multiple (OR, 4.4) hospitalizations, prior exposure to fluoroquinolones (OR, 10.6) and beta-lactams (OR, 8.6), presence of chronic obstructive pulmonary disease (COPD; OR, 5.9), and nosocomial origin of the bacteria (OR, 5.7). Multivariate analysis showed that presence of COPD (OR, 10.3), nosocomial origin of the bacteria (OR, 16.2), residence in a nursing home (OR, 7.4), and exposure to fluoroquinolones (OR, 10.7) were independently associated with LRSP colonization or infection. Thus, a distinct group of patients with COPD is the reservoir of LRSP.
Department of Microbiology, Division of Infectious Diseases, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China. plho@hkucc.hku
P L
PL
Ho
W S
WS
Tse
K W
KW
Tsang
T K
TK
Kwok
T K
TK
Ng
V C
VC
Cheng
R M
RM
Chan
D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000494:pharmacology*; D016022:Case-Control Studies; D004352:Drug Resistance, Microbial; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D064704:Levofloxacin; D008173:Lung Diseases, Obstructive / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015242:Ofloxacin / Q000494:pharmacology*; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D013296:Streptococcus pneumoniae / Q000187:drug effects*
D000890:Anti-Infective Agents; D064704:Levofloxacin; D015242:Ofloxacin