A Hospital-Based and Cross-Sectional Investigation on Clinical Characteristics of Pediatric Streptococcus pneumoniae Isolates in Beijing from 2015 to 2021

Abstract

Introduction Streptococcus pneumoniae ( S. pneumoniae ) is a major pathogen causing death in children. Few studies have evaluated the importance of S. pneumoniae in the identified bacteria in clinical work. This retrospective study aimed to reveal the rank of S. pneumoniae in determined bacteria isolated from children in Beijing, China, as well as the antimicrobial resistance of this pathogen. Methods The number of specimen for bacterial culture and of bacterial species were cumulated and ranked based on the data of the two largest children’s hospitals in Beijing from 2015 to 2021. The temporal change of S. pneumoniae culture, as well as the clinical data of S. pneumoniae isolates were collected and analyzed. The minimum inhibitory concentrations of antimicrobial agents were determined by BD Phoenix 100 automated system or Vitek 2 automated system for antimicrobial susceptibility testing. The breakpoints recommended by CLSI were adopted. Results During the 7-year study period, a total of 45,631 bacterial isolates were cultured from 462,144 submitted specimens, in which S. pneumoniae was the third frequent agent following S. aureus and H. influenza , and accounting for 8.79% of the isolates (4011/45,631). In the 4011 S. pneumoniae isolates, 2239 and 997 ones were, respectively, isolated from sputum and bronchial lavage fluid. Most of S. pneumoniae strains were identified in winter (34.7%) and spring (26.1%), and were mainly isolated from patients under 5 years old (77.1%). Low susceptible rate (27.6%) of CSF isolates was determined to penicillin according to the parenteral meningitis breakpoints, while high susceptible rate (56.9%) of non-CSF isolates was obtained according to the parenteral non-meningitis breakpoints. The isolates showed low sensitivity to erythromycin and tetracycline (<5%). All isolates were susceptible to vancomycin and linezolid. Conclusion The present results demonstrated that S. pneumoniae was one of the most commonly detected bacteria in current pediatric clinical tests, especially in young children under 5 years old, which emphasized the importance of prevention. Penicillin could still be the first empiric choice to treat non-meningitis pneumococcal infections, while erythromycin should not be involved in the treatment.

The spectrum of bacterial infectionin a large cohort of Chinese pediatric patients with inborn errors of immunity: a nine-year, retrospective, single-center study

“…β-lactamase production 68.63% (35/51) 42.9% [23] M. catarrhalis β-lactamase production 100% (26/26) 60.5% [23] , 100% [24] S. pneumoniae PNSP 4.35% (1/23) 39.4% [25] , 43.1% [26] S. aureus MRSA 55.17% (16/29) 34.5% [15] , 38.1 [27] K. pneumoniae EBSL 78.13% (25/32) 6.1% [23] K. pneumoniae CRKP 25.71% (9/35) 19.3% [15] E.coli EBSL 71.43% (15/21) 19.1% [23] E.coli CREC 38.10% (8/21) 16.3% [28] P. aeruginosa CRPA 25.81% (8/31) 12.8% [15] A. baumannii CRAB 70.59% (12/17) 45.4% [15] PNSP: Penicillin non-susceptible pneumococci (non-CNS).…”

“…Common drug-resistant bacteria in children with IEI have high AMR. [15,[23][24][25][26][27][28][29] This study summarized AMR of common drug-resistant bacteria in IEI patients (Table 3). For H. influenzae and M. catarrhalis, the β-lactamase production rates were 68.63 % and 100 %, respectively.…”