Antibiotic resistance profiles and multidrug resistance patterns of Streptococcus pneumoniae in pediatrics A multicenter retrospective study in mainland China

被引：55

作者：

Wang, Cai-yun ^{[1
]}

Chen, Ying-Hu ^{[1
]}

Fang, Chao ^{[2
]}

Zhou, Ming-ming ^{[2
]}

Xu, Hong-mei ^{[3
]}

Jing, Chun-mei ^{[4
]}

Deng, Hui-ling ^{[5
]}

Cai, Hui-jun ^{[6
]}

Jia, Kai ^{[6
]}

Han, Shu-zhen ^{[7
]}

Yu, Hui ^{[7
]}

Wang, Ai-min ^{[8
]}

Yin, Dan-dan ^{[8
]}

Wang, Chuan-qing ^{[8
]}

Wang, Wei ^{[9
]}

Huang, Wei-chun ^{[10
]}

Deng, Ji-kui ^{[11
]}

Zhao, Rui-zhen ^{[11
]}

Chen, Yi-ping ^{[12
]}

Yang, Ji-Hong ^{[13
,14
]}

Wang, Chun ^{[15
]}

Che, Yan-ran ^{[16
]}

Nie, Xiu-zhen ^{[17
]}

Wang, Shi-fu ^{[18
]}

Hao, Jian-hua ^{[19
]}

Zhang, Cong-hui ^{[20
]}

机构：

[1] Zhejiang Univ, Sch Med, Childrens Hosp, Infect Dis Dept, Hangzhou 310003, Zhejiang, Peoples R China

[2] Zhejiang Univ, Sch Med, Childrens Hosp, Clin Lab Dept, Hangzhou, Zhejiang, Peoples R China

[3] Chongqing Med Univ, Childrens Hosp, Infect Dis Dept, Chongqing, Peoples R China

[4] Chongqing Med Univ, Childrens Hosp, Clin Lab Dept, Chongqing, Peoples R China

[5] Xian Children Hosp, Dept Infect Dis, Xian, Shaanxi, Peoples R China

[6] Xian Children Hosp, Clin Lab, Xian, Shaanxi, Peoples R China

[7] Fudan Univ, Childrens Hosp, Dept Infect Dis, Shanghai, Peoples R China

[8] Fudan Univ, Childrens Hosp, Clin Microbiol Lab, Shanghai, Peoples R China

[9] Shanghai Jiao Tong Univ, Sch Med, Shanghai Childrens Med Ctr, Infect Dis Dept, Shanghai, Peoples R China

[10] Shanghai Jiao Tong Univ, Sch Med, Shanghai Childrens Med Ctr, Dept Clin Lab, Shanghai, Peoples R China

[11] Shenzhen Childrens Hosp, Dept Infect Dis, Shenzhen, Guangdong, Peoples R China

[12] Wenzhou Med Univ, Affiliated Hosp 2, Infect Dis Dept, Wenzhou, Zhejiang, Peoples R China

[13] Wenzhou Med Univ, Affiliated Hosp 2, Clin Lab Ctr, Wenzhou, Zhejiang, Peoples R China

[14] Wenzhou Med Univ, Yuying Childrens Hosp, Wenzhou, Zhejiang, Peoples R China

[15] Shanghai Jiao Tong Univ, Sch Med, Clin Lab, Childrens Hosp, Shanghai, Peoples R China

[16] Shanghai Jiao Tong Univ, Sch Med, Dept Gastroenterol & Infect Dis, Childrens Hosp, Shanghai, Peoples R China

[17] Shandong Univ, Qilu Childrens Hosp, Infect Dis Dept, Jinan, Shandong, Peoples R China

[18] Shandong Univ, Qilu Childrens Hosp, Dept Childrens Med Lab Diag Ctr, Jinan, Shandong, Peoples R China

[19] Kaifeng Childrens Hosp, Infect Dis Dept, Kaifeng, Henan, Peoples R China

[20] Kaifeng Childrens Hosp, Microbiol Examinat Dept, Kaifeng, Henan, Peoples R China

来源：

MEDICINE | 2019年 / 98卷 / 24期

关键词：

antibiotic resistance; children; invasive pneumococcal disease; multidrug resistance; Streptococcus pneumoniae; RESPIRATORY-TRACT INFECTION; ANTIMICROBIAL SUSCEPTIBILITY; SEROTYPE DISTRIBUTION; SURVEILLANCE; PATHOGENS; PREVALENCE; CHILDREN; TRENDS; JAPAN; ASIA;

D O I：

10.1097/MD.0000000000015942

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Emergent resistance to antibiotics among Streptococcus pneumoniae isolates is a severe problem worldwide. Antibiotic resistance profiles for S pneumoniae isolates identified from pediatric patients in mainland China remains to be established. The clinical features, antimicrobial resistance, and multidrug resistance patterns of S pneumoniae were retrospectively analyzed at 10 children's hospitals in mainland China in 2016. Among the collected 6132 S pneumoniae isolates, pneumococcal diseases mainly occurred in children younger than 5 years old (85.1%). The resistance rate of S pneumoniae to clindamycin, erythromycin, tetracycline, and trimethoprim/sulfamethoxazole was 95.8%, 95.2%, 93.6%, and 66.7%, respectively. The resistance rates of S pneumoniae to penicillin were 86.9% and 1.4% in non-meningitis and meningitis isolates, while the proportions of ceftriaxone resistance were 8.2% and 18.1%, respectively. Pneumococcal conjugate vaccine was administered to only 4.1% of patients. Penicillin and ceftriaxone resistance, underling diseases, antibiotic resistant risk factors, and poor prognosis appeared more frequently in invasive pneumococcal diseases. The incidence of multidrug resistance (MDR) was 46.1% in patients with invasive pneumococcal disease which was more than in patients with non-invasive pneumococcal disease (18.3%). Patients with invasive pneumococcal disease usually have several MDR coexistence. S pneumoniae isolates showed high resistance to common antibiotics in mainland China. Penicillin and ceftriaxone resistance rate of invasive streptococcal pneumonia patients were significantly higher than that of non-invasive S pneumoniae patients. Alarmingly, 46.1% of invasive clinical isolates were multidrug resistant, so it is important to continued monitor the resistance of S pneumoniae when protein conjugate vaccine (PCV13) is coming in mainland China.

引用

页数：7

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