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Invasive pneumococcal diseases in Chinese children: a multicentre hospital-based active surveillance from 2019 to

Xue Ning1, Lianmei Li2, Jing Liu3

  • 1Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China.

Emerging Microbes & Infections
|April 22, 2024
PubMed

Insights

Invasive pneumococcal disease (IPD) in Chinese children presents with high antibiotic resistance, particularly to macrolides and tetracyclines. Serotypes 19F, 14, and 23F are common, highlighting the need for vaccination and ongoing surveillance.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Invasive pneumococcal disease (IPD) remains a significant public health concern in children globally.
  • Streptococcus pneumoniae causes IPD, with varying serotype prevalence and antibiotic resistance patterns across regions.
  • Understanding the clinical and molecular epidemiology of IPD in China is crucial for effective prevention and treatment strategies.

Purpose of the Study:

  • To characterize the clinical features of IPD in Chinese pediatric patients.
  • To determine the serotype distribution and antibiotic susceptibility of Streptococcus pneumoniae isolates.
  • To identify molecular characteristics, including multi-locus sequence typing (MLST), of pneumococcal isolates.

Main Methods:

  • A multi-center prospective study was conducted in 19 Chinese hospitals from January 2019 to December 2021.
  • Data on demographic characteristics, risk factors, clinical outcomes (death, disability), and disease types were collected.
  • Serotyping, antibiotic susceptibility testing, and MLST were performed on collected pneumococcal isolates.

Main Results:

  • A total of 478 IPD cases were analyzed, with septicaemia, meningitis, and pneumonia being common presentations. The overall mortality rate was 9.6%.
  • The most prevalent serotypes were 19F (24.2%), 14 (17.7%), 23F (14.9%), 6B (10.4%), and 19A (9.6%).
  • High resistance rates were observed for macrolides (98.3%), tetracycline (94.1%), and trimethoprim/sulfamethoxazole (70.7%). Penicillin non-sensitive rates were 6.2% for non-meningitis and 83.3% for meningitis isolates. Specific serotype-ST combinations (e.g., 19F-ST271) showed high antibiotic resistance.

Conclusions:

  • This study provides essential data on the clinical spectrum and molecular epidemiology of IPD in Chinese children.
  • High rates of antibiotic resistance, particularly among common serotypes, underscore the challenges in managing IPD.
  • Improved pneumococcal vaccination coverage and continued surveillance are vital for reducing the burden of IPD in this population.

Keywords:
Chinese childrenInvasive pneumococcal diseasehospital-basedmulticentreserotype

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