Invasive Streptococcus pneumoniae infection among hospitalized patients in Jingzhou city, China, 2010-2012
Hui Jiang1, Yang Huai2, Hui Chen3
1Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
Background:
Streptococcus pneumoniae (Sp) is a leading cause of bacterial pneumonia, meningitis, and sepsis and a major source of morbidity and mortality worldwide. Invasive pneumococcal disease (IPD) is defined as isolation of Sp from a normally sterile site, including blood or cerebrospinal fluid. The aim of this study is to describe outcomes as well as clinical and epidemiological characteristics of hospitalized IPD case patients in central China.
Methods:
We conducted surveillance for IPD among children and adults from April 5, 2010 to September 30, 2012, in four major hospitals in Jingzhou City, Hubei Province. We collected demographic, clinical, and outcome data for all enrolled hospitalized patients with severe acute respiratory infection (SARI) or meningitis, and collected blood, urine, and cerebrospinal fluid (CSF) for laboratory testing for Sp infections. Collected data were entered into Epidata software and imported into SPSS for analysis.
Results:
We enrolled 22,375 patients, including 22,202 (99%) with SARI and 173 (1%) with meningitis. One hundred and eighteen (118, 3%) with either SARI or meningitis were Sp positive, 32 (0.8%) from blood/CSF culture, and 87 (5%) from urine antigen testing. Of those 118 patients, 57% were aged ≥65 years and nearly 100% received antibiotics during hospitalization. None were previously vaccinated with 7-valent pneumococcal conjugate vaccine (PCV 7), 23-valent pneumococcal polysaccharide vaccine, or seasonal influenza vaccine. The main serotypes identified were 14, 12, 3, 1, 19F, 4, 5, 9V, 15 and 18C, corresponding to serotype coverage rates of 42%, 63%, and 77% for PCV7, PCV10, and PCV13, respectively.
Conclusions:
Further work is needed to expand access to pneumococcal vaccination in China, both among children and potentially among the elderly, and inappropriate use of antibiotics is a widespread and serious problem in China.
Insights
Invasive pneumococcal disease (IPD) surveillance in central China revealed significant rates of infection, particularly in the elderly. Findings highlight the need for increased pneumococcal vaccination and improved antibiotic stewardship.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Streptococcus pneumoniae (Sp) is a primary cause of pneumonia, meningitis, and sepsis globally.
- Invasive pneumococcal disease (IPD) is defined by Sp isolation from sterile sites like blood or cerebrospinal fluid.
- This study focuses on the clinical and epidemiological characteristics of hospitalized IPD patients in central China.
Purpose of the Study:
- To describe the outcomes of hospitalized IPD case patients in central China.
- To detail the clinical characteristics of IPD cases.
- To analyze the epidemiological features of IPD in the region.
Main Methods:
- Conducted IPD surveillance in four hospitals in Jingzhou City, Hubei Province, from April 2010 to September 2012.
- Collected demographic, clinical, and outcome data from hospitalized patients with severe acute respiratory infection (SARI) or meningitis.
- Performed laboratory testing on blood, urine, and cerebrospinal fluid (CSF) for Sp detection using Epidata and SPSS for analysis.
Main Results:
- Enrolled 22,375 patients; 118 (3%) tested positive for Sp.
- The majority of Sp-positive patients (57%) were aged 65 years or older.
- Identified key Sp serotypes, with PCV13 covering 77% of isolates, and noted that none of the patients were previously vaccinated.
Conclusions:
- Emphasizes the need to expand pneumococcal vaccination access for children and the elderly in China.
- Highlights inappropriate antibiotic use as a significant and prevalent issue in China.
- Suggests a need for further research and intervention strategies for IPD control.
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