Clinical features of invasive pneumococcal disease and its antimicrobial resistance among children under the age of 5 years / 中国小儿急救医学

ABSTRACT

Objective To investigate the clinical characteristics of invasive pneumococcal disease (IPD) and its drug resistance among children under the age of 5 years.Methods Clinical characteristics of 45 children of IPD admitted to the Shengjing Hospital of China Medical University from 2009 to 2010 and antimicrobial non-susceptibility results were analyzed retrospectively.Results Forty-five cases of IPD were confirmed by positive culture of sterile body site,most of which occurred between April and June.Most of the IPD children were below the age of 2 years,which accounted for 66.7％ (30/45).The disease spectrum included bacteremia in 32 cases (71.1％),encephalitis in 9 cases (20.0％),empyema in 23 cases (51.1％),necrotizing pneumonia in 10 cases (22.2％).Pneumococcal non-susceptibility to erythromycin were found to be 100％,to clindamycin were 95％,to tetracycline were 95.12 ％,to trimethoprim-sulfamethoxaole were 80.49％,to chloramphenicol were 18.18％,while pneumococcal resisitanse to rifampicin,quinolones and vancomycin were 0.Eight of eleven and 18/24 were found to be pneumoccal resistance to penicillin and cephalosporin respectively and their minimum inhibitory concentrations were high.Twenty five cases were cured (55.6％).Fifteen cases were improved (33.3％).Four cases died (8.9％).One cases was retreated.All cases of death were under the age of 2 years.Conclusion IPD is more common with a high mortality rate among those under the ages of 2 years.Poor outcome is associated with Streptococcus pneumoniae resistance to antibiotics.