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Abstract：
BACKGROUND: Invasive pneumococcal disease (IPD) is a significant health concern in children worldwide. In this study, we aimed to analyze the clinical features, antibiotic resistance, and risk variables for poor outcomes in patients with IPD in Hangzhou.
METHODS: A retrospective single-centre study was performed using the pediatric intensive care (PIC) database from 2010 to 2018. The clinical characteristics, laboratory data, antimicrobial resistance, and risk factors for in-hospital mortality and sepsis in patients with IPD in intensive care units (ICUs) were analyzed systematically.
RESULTS: A total of 178 IPD patients were included in the study. The majority of the IPD children were 2-10 years old. Antimicrobial resistance tests of S. pneumoniae isolates revealed high resistance to erythromycin, tetracycline and compound sulfamethoxazole (SMZ-Co). All the isolates were sensitive to vancomycin, linezolid, moxifloxacin, telithromycin, ofloxacin, and levofloxacin. IPD patients may experience poor outcomes, including death and sepsis. The in-hospital mortality was 3.93%, and 34.27% of patients suffered from sepsis. Temperature (OR 3.80, 95% CI 1.62-8.87; P = 0.0021), Partial Pressure of Oxygen in Arterial Blood (PaO2) (OR 0.99, 95% CI 0.98-1.00; P = 0.0266), and albumin (OR 0.89, 95% CI 0.80-0.99; P = 0.0329) were found to be independent risk factors for sepsis in children with IPD.
CONCLUSIONS: Pediatric IPD deserves attention in China. Appropriate surveillance and antibiotic selection are crucial in managing resistant strains. Early identification of high-risk individuals with risk factors contributes to the development of appropriate treatment strategies.
METHODS: A retrospective single-centre study was performed using the pediatric intensive care (PIC) database from 2010 to 2018. The clinical characteristics, laboratory data, antimicrobial resistance, and risk factors for in-hospital mortality and sepsis in patients with IPD in intensive care units (ICUs) were analyzed systematically.
RESULTS: A total of 178 IPD patients were included in the study. The majority of the IPD children were 2-10 years old. Antimicrobial resistance tests of S. pneumoniae isolates revealed high resistance to erythromycin, tetracycline and compound sulfamethoxazole (SMZ-Co). All the isolates were sensitive to vancomycin, linezolid, moxifloxacin, telithromycin, ofloxacin, and levofloxacin. IPD patients may experience poor outcomes, including death and sepsis. The in-hospital mortality was 3.93%, and 34.27% of patients suffered from sepsis. Temperature (OR 3.80, 95% CI 1.62-8.87; P = 0.0021), Partial Pressure of Oxygen in Arterial Blood (PaO2) (OR 0.99, 95% CI 0.98-1.00; P = 0.0266), and albumin (OR 0.89, 95% CI 0.80-0.99; P = 0.0329) were found to be independent risk factors for sepsis in children with IPD.
CONCLUSIONS: Pediatric IPD deserves attention in China. Appropriate surveillance and antibiotic selection are crucial in managing resistant strains. Early identification of high-risk individuals with risk factors contributes to the development of appropriate treatment strategies.
摘要：
背景：侵袭性肺炎球菌病（IPD）是全世界儿童的重大健康问题。在这项研究中,我们的目的是分析临床特征，抗生素耐药性,杭州IPD患者预后不良的风险变量。
方法：2010年至2018年，使用儿科重症监护（PIC）数据库进行了一项回顾性单中心研究。临床特点,实验室数据,抗菌素耐药性，并系统分析重症监护病房(ICU)IPD患者院内死亡和脓毒症的危险因素.
结果：共178例IPD患者纳入研究。大多数IPD儿童为2-10岁。肺炎链球菌的耐药性试验显示对红霉素的高耐药性，四环素和复方磺胺甲恶唑（SMZ-Co）。所有分离株对万古霉素敏感,利奈唑胺,莫西沙星,泰利霉素,氧氟沙星,和左氧氟沙星.IPD患者可能会出现不良结果，包括死亡和败血症.住院死亡率为3.93%，34.27%的患者患有脓毒症。温度（OR3.80，95%CI1.62-8.87；P=0.0021），动脉血氧分压（PaO2）（OR0.99，95％CI0.98-1.00；P=0.0266），白蛋白（OR0.89，95％CI0.80-0.99；P=0.0329）是IPD患儿脓毒症的独立危险因素。
结论：小儿IPD在中国值得关注。适当的监测和抗生素选择对于管理耐药菌株至关重要。早期识别具有危险因素的高危个体有助于制定适当的治疗策略。
方法：2010年至2018年，使用儿科重症监护（PIC）数据库进行了一项回顾性单中心研究。临床特点,实验室数据,抗菌素耐药性，并系统分析重症监护病房(ICU)IPD患者院内死亡和脓毒症的危险因素.
结果：共178例IPD患者纳入研究。大多数IPD儿童为2-10岁。肺炎链球菌的耐药性试验显示对红霉素的高耐药性，四环素和复方磺胺甲恶唑（SMZ-Co）。所有分离株对万古霉素敏感,利奈唑胺,莫西沙星,泰利霉素,氧氟沙星,和左氧氟沙星.IPD患者可能会出现不良结果，包括死亡和败血症.住院死亡率为3.93%，34.27%的患者患有脓毒症。温度（OR3.80，95%CI1.62-8.87；P=0.0021），动脉血氧分压（PaO2）（OR0.99，95％CI0.98-1.00；P=0.0266），白蛋白（OR0.89，95％CI0.80-0.99；P=0.0329）是IPD患儿脓毒症的独立危险因素。
结论：小儿IPD在中国值得关注。适当的监测和抗生素选择对于管理耐药菌株至关重要。早期识别具有危险因素的高危个体有助于制定适当的治疗策略。
