Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, 6/F, Clinical Sciences Building, Shatin, Hong Kong.
Indian J Pediatr. 2010 Dec;77(12):1387-91. doi: 10.1007/s12098-010-0188-9. Epub 2010 Sep 16.
To describe pneumococcal diseases in pediatric intensive care unit (PICU) and non-PICU patients.
The clinical, serotypes, and antibacterial sensitivity patterns of all children admitted to the pediatric wards (including PICU) of a university-affiliated teaching hospital from 2007 through 2009 with pneumococcal isolates were reviewed.
Twelve cases of pneumococcal disease in children from 2007 through 2009 were reported. Five patients were admitted to PICU and 7 were general pediatric admissions. Four patients (2 PICU and 2 general pediatric) had received full or partial 7-valent pneumococcal vaccinations. All four patients recovered following systemic antibiotic treatment without sequelae. The serotypes of all PICU and some general pediatric cases were available and included 3, 6B, 19A and 19F. All isolates were sensitive to vancomycin. 50% were intermediate resistant/resistant to penicillin and 17% resistant to cefotaxime. PICU cases required longer total hospital stay (23 days vs 5 days, p=0.013). Three patients were ventilated and one received inotropic support. There was no death in this series.
Pneumococcal disease may develop despite prior vaccination. The expanded coverage of newer polyvalent pneumococcal vaccines might have prevented some, but not all, of these admissions.
描述小儿重症监护病房（PICU）和非 PICU 患儿的肺炎球菌病。
对 2007 年至 2009 年间入住某大学附属医院儿科病房（包括 PICU）的所有分离出肺炎球菌的患儿的临床、血清型和抗菌敏感性模式进行回顾性分析。
报告了 2007 年至 2009 年间 12 例儿童肺炎球菌病。5 例患儿入住 PICU，7 例为普通儿科患儿。4 例（2 例 PICU 和 2 例普通儿科）接受了全价或部分 7 价肺炎球菌疫苗接种。所有 4 例患儿均经全身抗生素治疗后痊愈，无后遗症。所有 PICU 和部分普通儿科患儿的血清型均可用，包括 3、6B、19A 和 19F。所有分离株对万古霉素均敏感。50%对青霉素中介耐药/耐药，17%对头孢噻肟耐药。PICU 患儿总住院时间较长（23 天 vs 5 天，p=0.013）。3 例患儿需要通气，1 例需要使用正性肌力药物。本系列研究中无死亡病例。
尽管进行了疫苗接种，但仍可能发生肺炎球菌病。新型多价肺炎球菌疫苗的广泛应用可能预防了其中部分患儿的住院，但并非全部。
