Clinical Distribution,Serotypes and Drug Resistance Analysis of 425 Cases of Invasive Pneumococcal Disease Infectious in Children
10.3969/j.issn.1671-7414.2024.01.021
- VernacularTitle:425例儿童侵袭性肺炎链球菌病感染的临床分布、血清型及耐药性分析
- Author:
Yu SHEN
1
;
Guanlin LI
Author Information
1. 南京医科大学姑苏学院,南京 211166;南京医科大学附属苏州医院/苏州市立医院,江苏苏州 215008
- Keywords:
children;
invasive pneumococcal disease;
bacterial serotype;
drug resistance
- From:
Journal of Modern Laboratory Medicine
2024;39(1):118-122,169
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the infection distribution,serotypes,and drug resistance of invasive pneumococcal disease(IPD)in children,and provide a reference for the standardized treatment of IPD and the rational use of antibiotics in clinical practice.Methods A total of 425 children with definitive diagnoses of IPD in the Department of Pediatrics,the Affiliated Suzhou Hospital of Nanjing Medical University between March 2019 and November 2022 were selected as the research subjects.Information from the medical records of these children was reviewed,clinical data was collected,serotyping by podoconiosis test on the specimens of Streptococcus pneumoniae strains sent for preservation was determined,and the susceptibility test was performed.Results A sum of 425 children with IPD(with a mean age of 2.16±0.93)were collected in this study.Analysis of clinical infection types showed 189 cases(44.47%)of bacteremia pneumonia,80 cases(18.82%)of simple bloodstream infection,76 cases(17.88%)of septic meningitis,11 cases(2.59%)of infectious pleurisy,9 cases(2.12%)of infective peritonitis,7 cases(1.65%)of bone and joint infection,7 cases(1.65%)of infective endocarditis,and 46 cases(10.82%)of other infections in combination.A total of 14 serotypes were confirmed in this study,with detection rates of 162 cases(38.12%),90 cases(21.18%),42cases(9.88%),38 cases(8.94%),14 cases(3.29%)and 8 cases(1.88%)for serotypes 19F,19A,14,23F,6A,and 6B,respectively.The susceptibility test indicated that the resistance rates of erythromycin and clindamycin were both high,with 95.53%(406/425)and 99.53(423/425),respectively,while the resistance rates of amoxicillin,cefepime,and cefotaxime were all relatively low,with 13.65%(58/425),9.06%(81/425),and 17.18%(73/425),respectively.Comparison between the two groups of cerebrospinal fluid(CSF)isolates and non-CSF isolates showed that the rates of resistance to penicillin were 69.74%and 24.07%(χ2=59.59,P<0.05),the resistance rates to cefepime were 50.00%and 12.32%(χ2=57.44,P<0.05),the resistance rates to meropenem were 40.79%and 29.23%(χ2=3.88,P<0.05),respectively,with statistically significant differences.Conclusion Cultivation identification and drug resistance monitoring of IPD should be strengthened in clinical work.Antibiotics should be effectively used according to the drug susceptibility results to minimize the drug resistance of Streptococcus pneumoniae and improve the efficacy of drug therapy.