Wang Cai-Yun, Chen Ying-Hu, Chen Xue-Jun, Xu Hong-Mei, Jing Chun-Mei, Deng Ji-Kui, Zhao Rui-Zhen, Deng Hui-Ling, Cao San-Cheng, Yu Hui, Wang Chuan-Qing, Wang Ai-Min, Lin Ai-Wei, Wang Shi-Fu, Cao Qing, Wang Xing, Zhang Ting, Zhang Hong, Hao Jian-Hua, Zhang Cong-Hui
Department of Infectious Disease, Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310052, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2019 Jul;21(7):644-649. doi: 10.7499/j.issn.1008-8830.2019.07.006.
To study the clinical characteristics, drug sensitivity of isolated strains, and risk factors of drug resistance in children with invasive pneumococcal disease (IPD).
The clinical characteristics and drug sensitivity of the isolated strains of 246 hospitalized children with IPD in nine grade A tertiary children's hospitals from January 2016 to June 2018 were analyzed.
Of the 246 children with IPD, there were 122 males and 124 females. Their ages ranged from 1 day to 14 years, and among them, 68 (27.6%) patients were less than 1 year old, 54 (22.0%) patients were 1 to 2 years old, 97 (39.4%) patients were 2 to 5 years old, and 27 (11.0%) patients were 5 to 14 years old. Pneumonia with sepsis was the most common infection type (58.5%, 144/246), followed by bloodstream infection without focus (19.9%, 49/246) and meningitis (15.0%, 37/246). Forty-nine (19.9%) patients had underlying diseases, and 160 (65.0%) had various risk factors for drug resistance. The isolated Streptococcus pneumoniae strains were 100% sensitive to vancomycin, linezolid, moxifloxacin, and levofloxacin, 90% sensitive to ertapenem, ofloxacin, and ceftriaxone, but had a low sensitivity to erythromycin (4.2%), clindamycin (7.9%), and tetracycline (6.3%).
IPD is more common in children under 5 years old, especially in those under 2 years old. Some children with IPD have underlying diseases, and most of the patients have various risk factors for drug resistance. Pneumonia with sepsis is the most common infection type. The isolated Streptococcus pneumoniae strains are highly sensitive to vancomycin, linezolid, moxifloxacin, levofloxacin, ertapenem, and ceftriaxone in children with IPD.
研究侵袭性肺炎球菌病(IPD)患儿的临床特征、分离菌株的药敏情况及耐药危险因素。
分析2016年1月至2018年6月期间9家三级甲等儿童医院收治的246例IPD住院患儿的临床特征及分离菌株的药敏情况。
246例IPD患儿中,男性122例,女性124例。年龄范围为1天至14岁,其中68例(27.6%)患儿年龄小于1岁,54例(22.0%)患儿年龄为1至2岁,97例(39.4%)患儿年龄为2至5岁,27例(11.0%)患儿年龄为5至14岁。肺炎伴脓毒症是最常见的感染类型(58.5%,144/246),其次是无明确感染灶的血流感染(19.9%,49/246)和脑膜炎(15.0%,37/246)。49例(19.9%)患儿有基础疾病,160例(65.0%)患儿有各种耐药危险因素。分离出的肺炎链球菌菌株对万古霉素、利奈唑胺、莫西沙星和左氧氟沙星的敏感性为100%,对厄他培南、氧氟沙星和头孢曲松的敏感性为90%,但对红霉素(4.2%)、克林霉素(7.9%)和四环素(6.3%)的敏感性较低。
IPD在5岁以下儿童中更为常见,尤其是2岁以下儿童。部分IPD患儿有基础疾病,多数患儿有各种耐药危险因素。肺炎伴脓毒症是最常见的感染类型。IPD患儿分离出的肺炎链球菌菌株对万古霉素、利奈唑胺、莫西沙星、左氧氟沙星、厄他培南和头孢曲松高度敏感。