RESUMO
OBJECTIVES: To compare nasopharyngeal colonization between children with HIV-1 infection and those without HIV-1 infection, with special emphasis on nasopharyngeal carriage of Staphylococcus aureus. METHODS: This hospital-based cross-sectional study was carried out in the Paediatric Day Hospital of a teaching hospital. Nasopharyngeal swabs were collected in 93 children aged up to 18 years old born to HIV-positive mothers (31 children with HIV-1 infection and 62 age-matched non-infected children). RESULTS: The prevalence of nasopharyngeal colonization by S. aureus was higher among children with HIV-1 infection compared with those without HIV-1 infection (45.16% vs. 12.9%, p = 0.001). After adjusting all potential confounders, HIV-1 infection was an independent risk factor for nasopharyngeal colonization by S. aureus, with a prevalence ratio of 4.29 (95% confidence interval: 1.72-10.70). CONCLUSION: Children with HIV-1 infection had a higher prevalence of nasopharyngeal colonization by S. aureus than children without HIV-1 infection. Most of the isolated strains of S. aureus were methicillin-susceptible.
Assuntos
Infecções por HIV/virologia , Nasofaringe/microbiologia , Infecções Estafilocócicas/virologia , Staphylococcus aureus/isolamento & purificação , Brasil/epidemiologia , Estudos de Casos e Controles , Pré-Escolar , Intervalos de Confiança , Estudos Transversais , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , HIV-1/fisiologia , Hospitais de Ensino , Humanos , Lactente , Recém-Nascido , Masculino , Distribuição de Poisson , Prevalência , Fatores de Risco , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/crescimento & desenvolvimentoRESUMO
The irrational use of antibiotics is incriminated for the escalating antimicrobial resistance problem worldwide. This cross-sectional survey was conducted to describe patterns of antibiotic use in community-based pediatric outpatients in the southern region of Brazil. A sample of children (29 days to 18 years of age) was selected from each community-based outpatient clinic. Information related to antibiotic use in the child was obtained by interview with their parents using a structured questionnaire. Of 489 children, 201 (41.1 per cent) had received at least one antimicrobial course in the previous 2 months. The most commonly prescribed antibiotic was amoxicillin (54.0 per cent) and broad-spectrum agents were used in 15.3 per cent of antimirobial courses. Acute respiratory infections were the most frequent diagnosis for antibiotic prescribing (91.2 per cent), but at least 39.5 per cent were conditions of presumed viral etiology. Antibiotic use in the previous 2 months was more likely in children younger than 2 years (PR 1.36, 95 per cent CI 1.10-1.69); with chronic diseases (PR 1.38, 95 per cent CI 1.10-1.75); with higher paternal education level (PR 1.38, 95 per cent CI 1.11-1.72); with parents' pressure on physician for antibiotics (PR 1.66, 95 per cent CI 1.05-2.64) and with parental self-prescribing habit (PR 1.47, 95 per cent CI 1.06-2.04). Antibiotic use in children increased with mother's age (p=0.03 for linear trend). In conclusion, antibiotic prescribing is very common in community-based pediatric outpatients in the southern region of Brazil and inappropriate use is frequent. The independent risk factors for antibiotic use are child's age under 2 years, the presence of chronic diseases in the child, older mother, higher paternal education level, parents' pressure on physician and parental self-prescribing habit.