Clinical characteristics and drug resistance analysis of 224 children with Streptococcus pneumoniae infection

doi:10.3877/cma.j.issn.1674-1358.2019.05.002

Abstract

Abstract:

Objective

To investigate the clinical characteristics and drug resistance of children infected with Streptococcus pneumoniae.

Methods

The clinical data of 224 cases with Streptococcus pneumoniae infection were selected by random sampling from January 2015 to April 2018 in the Outpatient Department of Children’s Hospital Affiliated to Nanjing Medical University. The age distribution of children with Streptococcus pneumoniae infection, the seasonal distribution, serum types and the drug resistance to antibiotics of Streptococcus pneumoniae were analyzed, respectively.

Results

The incidence of Streptococcus pneumoniae infection among children aged 1 month to 1 year old was 56.25% (126/224), which was significantly higher than that of cases aged 1-3 years old (23.21%, 52/224) and 3-7 years old (20.54%, 46/224), both with significant differences (χ² = 51.045, 60.398; both P < 0.001). The rate of cases with Streptococcus pneumoniae infection in winter (52.67%, 118/224) was significantly higher than that in spring (20.09%, 45/224), summer (12.95 %, 29/224) and autumn (14.28%, 32/224), with significant differences (χ² = 51.392, 80.200, 74.126; all P < 0.001). There was no significant difference in the annual incidence of Streptococcus pneumoniae infection from 2014 to 2017 (χ² = 5.191, P = 0.158). The 224 Streptococcus pneumoniae strains involved 11 serotypes/groups, mainly distributed in 19F, 19A, 14, 9V, 23F, 6B, 8, 7F, 7A and others, while 11 strains could not be classified. Different serotypes were resistant to penicillin, and the insensitivity rate of penicillin (meningitis) was 75.00%. Different serotypes had different resistance to penicillin, and the insensitivity rate of penicillin (meningitis) was 75.00% (52/68), which was significantly higher than that of penicillin (non-meningitis)[56.41% (88/156)], with significant difference (χ² = 69.142, P < 0.001). The resistance rates of Streptococcus pneumoniae to erythromycin, compound norepinephrine and clindamycin were 84.82% (190/224), 78.13% (175/224) and 75.89% (170/224), respectively. But the sensitivity rates to vancomycin and chloramphenicol were 100.00% (224/224) and 96.44% (216/224), respectively.

Conclusions

The clinical characteristics of age, season, serum distribution and drug resistance in children with Streptococcus pneumoniae infection were helpful to guide the clinical and rational application of the antibacterial drugs.

Key words: Children, Streptococcus pneumoniae, Serotype distribution, Drug resistance, Sensitivity

Fei Han, Jincheng Dai, Hang Sun, Hua Tan, Xuemei Liu. Clinical characteristics and drug resistance analysis of 224 children with Streptococcus pneumoniae infection[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2019, 13(05): 357-361.

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References 25

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指标		株数	感染率（%）
?	年龄	?	?
?	1个月～1岁	126	56.25
?	1～3岁	52	23.21
?	3～7岁	46	20.54
?	χ²值	?	79.767
?	P值	?	< 0.001
季节		?	?
?	春季	45	20.09
?	夏季	29	12.95
?	秋季	32	14.28
?	冬季	118	52.67
?	χ²值	?	125.476
?	P值	?	< 0.001
年度		?	?
?	2014年	55	24.55
?	2015年	48	21.43
?	2016年	53	23.66
?	2017年	68	30.35
?	χ²值	?	5.191
?	P值	?	0.158

指标		株数	感染率（%）
?	年龄	?	?
?	1个月～1岁	126	56.25
?	1～3岁	52	23.21
?	3～7岁	46	20.54
?	χ²值	?	79.767
?	P值	?	< 0.001
季节		?	?
?	春季	45	20.09
?	夏季	29	12.95
?	秋季	32	14.28
?	冬季	118	52.67
?	χ²值	?	125.476
?	P值	?	< 0.001
年度		?	?
?	2014年	55	24.55
?	2015年	48	21.43
?	2016年	53	23.66
?	2017年	68	30.35
?	χ²值	?	5.191
?	P值	?	0.158

抗菌药物	株数	耐药（%）	中介（%）	敏感（%）
青霉素（脑膜炎）	68	75.00	10.29	14.71
青霉素（非脑膜炎）	156	56.41	6.42	37.17
红霉素	224	84.82	3.13	12.05
复方新诺明	224	78.13	6.70	15.17
克林霉素	224	75.89	3.13	20.98
万古霉素	224	0.00	0.00	100.00
氯霉素	224	2.23	1.33	96.44

抗菌药物	株数	耐药（%）	中介（%）	敏感（%）
青霉素（脑膜炎）	68	75.00	10.29	14.71
青霉素（非脑膜炎）	156	56.41	6.42	37.17
红霉素	224	84.82	3.13	12.05
复方新诺明	224	78.13	6.70	15.17
克林霉素	224	75.89	3.13	20.98
万古霉素	224	0.00	0.00	100.00
氯霉素	224	2.23	1.33	96.44

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