ปัจจัยที่มีความสัมพันธ์กับการเป็นพาหะของเชื้อ Streptococcus pneumoniae และการดื้อยาต้านจุลชีพในเด็กสุขภาพดีของศูนย์เด็กเล็ก ในโรงพยาบาลส่งเสริมสุขภาพแห่งหนึ่ง

Abstract

ABSTRACT

This was a cross sectional study in 1-5 years old preschool children attending a day-care center of a Health Promotional Hospital to evaluate the carriage rate of Streptococcus pneumoniae in oropharynx and related factors. Antimicrobial susceptibility test was determined by disk diffusion method. Among 189 participated children, 95 were boys and 94 were girls. Data analysis was done by using percentage, Chi-square test and Multiple logistic regression.

Oropharyngeal carriage rate of S. pneumoniae among 189 children was 28.6%. Factors related to S. pneumoniae carriage were being main caregiver of the parents (p = 0.030), maternal age of more than 30 years (p = 0.046), and injected pharynx on physical examination (p < 0.005). Among the two most commonly used antibiotics in clinical practice, 68.4% of S. pneumoniae were resistant to penicillins and 42.1% to erythromycin. Twenty five percent of S. pneumoniae were found to resist to the injectable form of antibiotics, cefotaxime, but not for vancomycin. The study showed that child care by the main caregiver and the signs of upper respiratory tract infection were the important factors related to the carriage rate. This study also demonstrated the high prevalence rate of antimicrobial resistance to the commonly used antibiotics. The optimal use of antibiotics should be promoted to prevent the increasing of antibiotic resistance among this organism.

Key words: Streptococcus pneumoniae, antimicrobial resistance, day-care center, main caregiver, carrier