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Updated: Jan 22, 2026
Experimental Human Pneumococcal Carriage
Published on: February 15, 2013
[Clinical characteristics and drug sensitivity in children with invasive pneumococcal disease: a multicenter study]
Cai-Yun Wang1, Ying-Hu Chen, Xue-Jun Chen
1Department of Infectious Disease, Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310052, China. cyh18@zju.edu.cn.
Insights
Invasive pneumococcal disease (IPD) is most common in children under five, often presenting as pneumonia with sepsis. Streptococcus pneumoniae strains show high sensitivity to key antibiotics like vancomycin and ceftriaxone.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Invasive pneumococcal disease (IPD) remains a significant global health concern in pediatric populations.
- Understanding clinical patterns and antimicrobial susceptibility is crucial for effective management and treatment strategies.
Purpose of the Study:
- To investigate the clinical features of IPD in hospitalized children.
- To determine the drug sensitivity profiles of isolated Streptococcus pneumoniae strains.
- To identify risk factors associated with antimicrobial resistance in pediatric IPD cases.
Main Methods:
- A retrospective analysis of 246 hospitalized children diagnosed with IPD across nine tertiary children's hospitals.
- Data collected from January 2016 to June 2018, including clinical characteristics and antimicrobial susceptibility testing of isolated strains.
- Evaluation of patient demographics, infection types, underlying conditions, and risk factors for drug resistance.
Main Results:
- IPD predominantly affected children under five years old (67%), with pneumonia and sepsis being the most frequent clinical presentation (58.5%).
- Isolated Streptococcus pneumoniae strains exhibited high sensitivity (>90%) to vancomycin, linezolid, moxifloxacin, levofloxacin, ertapenem, and ceftriaxone.
- Low sensitivity was observed for erythromycin (4.2%), clindamycin (7.9%), and tetracycline (6.3%), with 65% of patients presenting risk factors for drug resistance.
Conclusions:
- IPD is more prevalent in young children, particularly those under two years old, with pneumonia and sepsis as common manifestations.
- While certain antibiotics like vancomycin and ceftriaxone remain highly effective, the presence of risk factors highlights the need for ongoing surveillance of antimicrobial resistance.
- Effective treatment of pediatric IPD relies on understanding local resistance patterns and utilizing appropriate antimicrobial agents.
Objective:
To study the clinical characteristics, drug sensitivity of isolated strains, and risk factors of drug resistance in children with invasive pneumococcal disease (IPD).
Methods:
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.
Results:
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%).
Conclusions:
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.
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