Clinical features of invasive Streptococcus pneumoniae disease in children and early warning indicators of severe case
10.3969/j.issn.1671-8348.2024.08.009
- VernacularTitle:儿童侵袭性肺炎链球菌病临床特征及重症早期预警指标分析
- Author:
Xuhui CHEN
1
;
Hongbo XIE
;
Yuqiong LUO
;
Feiling WANG
;
Xiaoyue LIU
;
Lijuan WU
;
Ping JIN
Author Information
1. 暨南大学附属深圳市宝安区妇幼保健院PICU,广东深圳 518106
- Keywords:
invasive pneumococcal disease;
drug resistance;
serotype;
pneumococcal conjugate vaccine;
children;
intensive care unit
- From:
Chongqing Medicine
2024;53(8):1167-1172
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features in children with invasive pneumococcal disease (IPD) and early warning indicators of severe case.Methods The case data of 101 children inpatients with IPD isolated Streptococcus pneumoniae (Sp) at least once blood culture in this hospital from January 2007 to De-cember 2021 were collected retrospectively.The children patients were divided into the pediatric intensive care unit (PICU) group (35 cases) and general ward group (66 cases) according to whether or not entering PICU during hospitalization.The general clinical data,infection types and results of drug sensitivity test and bacteri-al strain serotype identification were compared between the two groups and analyzed.Results Compared with the general ward group,the male proportion,proportions of complicating nervous system disease and iron-defi-ciency anemia,winter incidence rate,disturbance of consciousness,convulsion,dyspnea,heart rate increase,oc-currence rate of vomiting and diarrhea,proportion of peripheral blood neutrophilic granulocytes,C reactive protein (CRP),lactic dehydrogenase (LDH) level,Hb<90 g/L,LDH>700 U/L,creatine kinase isoenzyme-MB (CK-MB) abnomality,proportions of bacterial meningitis,sepsis and severe pneumonia in the PICU group were higher,the proportion of 3-97 percentile of body weight,bronchopneumonia and no-focus blood stream infection were lower,WBC,Hb and albumin level were lower,and the differences were statistically significant (P<0.05).Eleven kinds of serotypes were identified in this study,ranking the top five in order were 6B,14,19F,23F and 19A.Pneumococcal 13-valent conjugate vaccine (PCV13) could cover 96.9％ of the IPD sero-types.The multivariate logistic regression analysis showed that consciousness disturbance,convulsion,per-centage of neutrophils increase,Hb<90 g/L,LDH>700 U/L and CK-MB abnormality indicated the condition of IPD children patients was critical,which was the early-warning indicator of entering PICU (P<0.05).Con-clusion Severe IPD lacks the early specific early-warning indicator,and the cover rate of PCV13 is high.
