Analysis of serotype and clinical manifestation of 80 children with invasive pneumococcal disease in Suzhou
10.3760/cma.j.issn.1673-4912.2018.12.011
- VernacularTitle:苏州地区儿童侵袭性肺炎链球菌病80例血清学分型和临床特征
- Author:
Zhong XU
1
;
Jin ZHANG
;
Meilin HAN
;
Lili HUANG
;
Yunzhen TAO
;
Ying LI
;
Tao ZHANG
;
Yanhong LI
;
Zhenjiang BAI
Author Information
1. 215025,苏州大学附属儿童医院重症医学科
- Keywords:
Pneumococcus;
Serotype;
Invasive disease;
Dead;
Drug resistance
- From:
Chinese Pediatric Emergency Medicine
2018;25(12):933-938
- CountryChina
- Language:Chinese
-
Abstract:
Objective To understand serotypes and clinical manifestation of children with invasive pneumococcal disease (IPD) in Suzhou,so as to find a better strategy for reducing the incidence and mortality of IPD. Methods Eighty children with IPD were enrolled into our study from January 2011 to December 2015. The data of epidemiology,serotype,clinical manifestation,laboratory results and prognosis were collected and analyzed. Results The mortality of 80 children with IPD was 17. 5%(14/80). Sixty percent of them were younger than 2 years old,and 78. 6% of 14 dead cases were younger than 2 years old,the median age of dead group 0. 68 (0. 45,2. 07) years was younger than 1. 61 (0. 85,3. 45) years of survival group ( P <0. 05). The incidence rates of hyperpyrexia,vomiting and somnolence in dead group were higher than those in survival group before admission ( P <0. 05), the incidence rates of shock, DIC, respiratory failure, AKI, seizure or coma in dead group were higher than those in survival group ( P<0. 05). The coincidence rate between choice of antibiotics before admission and drug sensitivity test was 15. 0%(12/80),the mortality of coincident group (coincidence between choice of antibiotics and drug sensitivity test) 8. 3% was lower than 16. 2% of non-coincident group with no statistical differences ( P>0. 05). The drug resistance rates of 80 pneumococcus to Erythromycin,Clindamycin,Tetracycline,Sulfamethoxazole,Penicillin,Cefotaxime,Amoxi-cillin,Chloramphenicol,Vancomycin and Levofloxacin were 100% (80/80),98. 8% (79/80),88. 8%(71/80),71. 3%(57/80),48. 8%(39/80),32. 5%(26/80),8. 8%(7/80),5. 0%(4/80),0(0/80) and 0(0/80) respectively. Eight serotypes of 80 IPD cases were listed in descending order:6B(25. 5%,20/80),14 (23. 8%,19/80),19F(15. 0%,12/80),19A(15. 0%,12/80),23F(8. 8%,7/80),20(5. 0%,4/80),9V (5. 0%,4/80) and 15B/C(2. 5%,2/80),and 6 serotypes of 14 dead cases were:6B(35. 7%,5/14),14 (28. 6%,4/14),19F(14. 3%,2/14),19A(7. 1%,1/14),23F(7. 1%,1/14) and 20(7. 1%,1/14); the coverage of IPD serotypes of 7-valent pneumococcal conjugate vaccine (PCV7) 77. 5%(62/80) was lower than 92. 5%(74/80) of 13-valent pneumococcal conjugate vaccine (P <0. 05). Conclusion Majority of dead cases of IPD is always younger than 2 years. The low coincidence rate of choices of antibiotics to inva-sive pneumococcus outpatient and low rate of PCV immunization in China are responsible for the high mortal-ity of IPD. Timely recognition of continuous hyperpyrexia, vomiting and somnolence in early stage and appropriate use of antibiotics is the key to improve the outcome of IPD. Thirteen-valent pneumococcal conju-gate vaccine immunization provides a robust strategy for reducing the incidence and mortality of IPD.
