Analysis of clinical characteristics of hospitalized children with pneumococcal disease
Objective To summarize clinical characteristics of hospitalized children with pneumococcal disease(PD)and provide a theoretical basis for the prevention and treatment the disease.Methods From May 1,2019,to April 30,2022,a total of 245 pediatric patients diagnosed with PD and hospitalized at Guangzhou Women and Children's Medical Center of Guangzhou Medical University were collected as the study subjects.They were categorized into groups based on the presence of underlying diseases:those with underlying diseases(n=72)and those without underlying diseases(n=173).Additionally,patients were divided into groups based on their susceptibility to antibiotics as determined by bacterial sensitivity testing:multidrug resistance(MDR)group(n=125)and non-MDR group(n=120).Furthermore,patients were categorized based on whether they had received at least one dose of pneumococcal vaccine before the onset of illness:vaccinated group(n=60)and unvaccinated group(n=185).And the demographic characteristics,underlying disease,pneumococcal multidrug resistance,presence of concurrent infections with other pathogens,severity rate,proportion of patients receiving mechanical ventilation,disease burden,prognosis,and vaccine-related data of the pediatric patients were recorded and analyzed.Results The incidence of PD was highest in children aged 3 and below(79.18％)with concurrent infections with other pathogens observed in 52.24％(128/245)of cases.The rate of multidrug-resistant pneumococcal infection was 51.02％(125/245)and 37.55％(92/245)of cases required treatment in the pediatric intensive care unit(PICU).Underlying diseases were present in 29.39％(72/245)of cases,while the proportion of patients who had received at least one dose of pneumococcal vaccine before the onset of illness was 24.49％(60/245).Additionally,22.86％(56/245)required assisted ventilation via endotracheal intubation.Invasive pneumococcal disease accounted for 17.55％(43/245)of cases.The discharge rate with improvement was 95.10％(233/245),with 4.90％(12/245)of cases exhibiting residual sequelae,and no deaths were reported.Among patients with underlying diseases,the rates of MDR occurrence(x2=9.989),duration of hospitalization(Z=-5.258),hospitalization costs(Z=-6.490),oxygen supplementation rate(x2=22.407),admission to the PICU(x2=46.942),proportion requiring endotracheal intubation and mechanical ventilation(x2=55.688),and occurrence of residual sequelae(x2=8.450)were all higher than those in the group without underlying diseases,and the differences were statistically significant(P＜0.05).The proportion of PD patients with concurrent infections in the MDR group was lower than that in the non-MDR group(x2=9.914).The occurrence rate of residual sequelae was higher in the MDR group than in the non-MDR group(x2=5.272).Both differences were statistically significant(P＜0.05).Among PD patients in the vaccinated group,the occurrence rates of MDR(x2=33.973),oxygen supplementation(x2=18.727),and the proportion requiring endotracheal intubation and mechanical ventilation(x2=11.354)were all lower than those in the unvaccinated group,and the differences were statistically significant(P＜0.05).No residual sequelae were observed in the vaccinated group,while the occurrence rate of residual sequelae in the unvaccinated group was 6.49％,with a statistically significant difference(P=0.042).Conclusion PD tends to occur at a young age in children,and antimicrobial resistance is a serious concern.Children with underlying diseases bear a heavier disease burden and should be vaccinated against pneumococcus in a timely manner.
万方数据
维普
