Clinical characteristics and antibiotic sensitivity in children with invasive pneumococcal disease / 中华实用儿科临床杂志

ABSTRACT

Objective:To investigate the clinical characteristics of children with invasive pneumococcal di-sease (IPD) and the sensitivity of Streptococcus pneumoniae (SP) isolates to antibacterial drugs, so as to provide the reference for diagnosis and treatment of IPD. Methods:The clinical data of IPD patients in the Children′s Hospital of Chongqing Medical University from January 2014 to December 2018 as well as the drug sensitivity results of SP isolates were retrospectively analyzed.Results:The male to female ratio of 139 patients enrolled was 1.5∶1.0.One hundred and sixteen (83.5%) patients were under 5 years old.Of the 31 patients (22.3%) with underlying diseases, 7 patients (5.1%) had hematological malignancy, 6 patients (4.3%) had congenital heart diseases, and 18 patients (12.9%) were immunosuppressed.The common sources of infection were the respiratory system (59.0%, 82/139 cases) and the central nervous system (28.8%, 40/139 cases). The in-hospital mortality rate among them was 15.8% (22/139 cases). More than 90.0% of the SP isolates were insusceptible to Erythromycin, Tetracycline and Clindamycin, and 74.8% (104/139 cases) of the isolates were insusceptible to Meropenem.The susceptibility rate of SP isolates to Amoxicillin was 69.1% (96/139 cases). The SP isolates were completely susceptible to Vancomycin, Linezolid, Moxifloxacin and Ofloxacin.Meningitis isolates had lower susceptibility rates to Penicillin (10.0% vs. 54.5%, P<0.001) and Cefotaxime (32.5% vs. 74.7%, P<0.001) than those in nonmeningitis isolates. Conclusions:Children under 5 years old with underlying diseases are susceptible to IPD and have a high mortality rate.The SP isolates in children with IPD are highly insusceptible to Erythromycin, Tetracycline, Clindamycin and Meropenem, and completely susceptible to Vancomycin, Linezolid, Moxifloxacin and Ofloxacin.Meningitis isolates are less susceptible to Penicillin and Cefotaxime than non-meningitis isolates.