Risk Factors for Acquisition of Levofloxacin-Resistant Streptococcus pneumoniae: A Case-Control Study

• Published in: Clinical infectious diseases 2001-03, Vol.32 (5), p.701-707
• Main Authors: Ho, P. L., Tse, W. S., Tsang, Kenneth W. T., Kwok, T. K., Ng, T. K., Cheng, Vincent C. C., Chan, Robert M. T.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anti-Infective Agents - pharmacology; Antibacterial agents; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Case-Control Studies; Chronic obstructive pulmonary disease; Drug Resistance, Microbial; Female; Fluoroquinolones; Hong Kong - epidemiology; Hospitalization; Humans; Infections; Levofloxacin; Lung Diseases, Obstructive - epidemiology; Lung Diseases, Obstructive - microbiology; Major Articles; Male; Medical sciences; Microbial Sensitivity Tests; Middle Aged; Nursing homes; Ofloxacin - pharmacology; Operating rooms; Pharmacology. Drug treatments; Pneumococcal Infections - epidemiology; Pneumococcal Infections - microbiology; Predisposing factors; Retrospective Studies; Risk Factors; Sputum; Streptococcus pneumoniae; Streptococcus pneumoniae - drug effects; Tropical medicine
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/319222

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 β-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.