title: [Invasive pneumococcal pneumonia in children 0-24 months old: does bacterial resistance affect outcome].
abstract: BACKGROUND
  In Uruguay community acquired bacterial pneumonia is a significant cause of morbidity and mortality. S. pneumoniae is the most frequent agent. The disease is more severe in children less than two years old. The relationship between pneumococcal penicillin resistance and outcome is still an unresolved problem.
  
  
  OBJECTIVE
  To compare the outcome of children 0 to 24 months old hospitalized in the Hospital Pediátrico-Centro Hospitalario Pereira Rossell, with invasive pneumococcal pneumonia caused by S. pneumoniae susceptible and resistant to penicillin.
  
  
  METHODS
  Children 0 to 24 months old with invasive pneumococcal pneumonia, admitted between January 1st 1998 and December 31st 2005 were included. Susceptibility to penicillin was defined as a MIC < 0.06 microg/ml, reduced susceptibility was defined as a MIC of 0.1 to 1 microg/ml (intermediate) and as a MIC >or= 2 microg/ml (resistant). Outcome was evaluated with the following criteria: empyema, sepsis, septic shock, mechanical ventilation, and death. Length of hospital stay and outcome were compared in both groups.
  
  
  RESULTS
  Inclusion criteria were met by 168 children. S. pneumoniae was susceptible to penicillin in 90 children and with reduced susceptibility in 78. Both groups were similar in age, comorbidity, nutritional status and initial antibiotic treatment. There were no significant differences in outcome and length of hospital stay.
  
  
  CONCLUSIONS
  S. pneumoniae resistance to penicillin did not affect the outcome of pneumonia in this group of children.
authors.affiliation: Clínica Pediátrica, Hospital Pediátrico, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay. mcpirez@yahoo.com
authors.forename: M C
authors.initials: MC
authors.lastname: Pírez García
authors.forename: G
authors.initials: G
authors.lastname: Giachetto Larraz
authors.forename: C
authors.initials: C
authors.lastname: Romero Rostagno
authors.forename: C
authors.initials: C
authors.lastname: Zabala Chain
authors.forename: G
authors.initials: G
authors.lastname: Algorta Rusiñol
authors.forename: A
authors.initials: A
authors.lastname: Montano Lotito
authors.forename: A M
authors.initials: AM
authors.lastname: Ferrari Castilla
mesh_terms: D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010403:Penicillin Resistance; D011018:Pneumonia, Pneumococcal / Q000188:drug therapy* / Q000401:mortality