Laboratory Surveillance Of Acute Upper Respiratory Tract Infections Of Streptococcus Pneumoniae And Haemophilus Influenzae In A Children’s Hospital In Yunnan Province From 2021 To 2022

Objective(s):Through the epidemiological characteristics and laboratory surveillance of Streptococcus pneumoniae and Haemophilus influenzae in upper respiratory tract infections in a children’s hospital in Yunnan Province from 2021 to2022,we understand the distribution of Streptococcus pneumoniae and Haemophilus influenzae in the population of children attending a children’s hospital in Yunnan Province;grasp the distribution characteristics and drug resistance status of Streptococcus pneumoniae and Haemophilus influenzae in children attending the hospital,and also investigate the distribution of Streptococcus pneumoniae and Haemophilus influenzae in children.The study also investigated the vaccination status of Streptococcus pneumoniae and Haemophilus influenzae in children,and provided a basis for the development of prevention and control strategies and measures for diseases caused by Streptococcus pneumoniae and Haemophilus influenzae,as well as the rational use of antimicrobial drugs in clinical practice,and also provided data support for the inclusion of relevant vaccines in childhood immunization programs.Methods:1.Using the method of current survey,we collected pharyngeal swabs from pediatric patients with acute upper respiratory tract infections attending a children’s hospital in Yunnan Province at the fever clinic once a week from March 2021 to June2022 to investigate the basic information,clinical symptoms and biochemical indicators of the children,and used the Yunnan Provincial Immunization Planning Information System to query the vaccination history of each case.2.The samples were tested by Taqman probe method Real-time PCR to detect specimen DNA,and nucleic acid positive specimens were isolated and cultured using Streptococcus pneumoniae and Haemophilus influenzae selective media;the isolated suspected target bacteria were subjected to API-NH identification card test,Optochin test,bile lysis test and V+X factor tests were performed for validation.Minimal Inhibitory Concentration(MIC)values for Streptococcus pneumoniae and Haemophilus influenzae were determined using the micro nutrient broth dilution method with reference to the Clinical and Laboratory Standards Institute(CLSI).The results were determined and the drug sensitivity results were obtained.3.Excel2020 was used for data collation and SPSS20.0 was used for statistical analysis.Measurement data consistent with normal distribution was represented by"mean±standard deviation",while those inconsistent with normal distribution were represented by"median".Count data use cases or percentage,compares theχ~2 test.Results:1.In this study,a total of 1021 specimens were collected from March 2021 to June 2022 at the outpatient clinic of Kunming Children’s Hospital,aged 0-16 years;there were more males than females,with a male to female ratio of 1.3:1,and the population was mainly preschool-aged children.the detection rates of Sp and Hi were27.72%and 25.86%;the separation success rates were 2.47%and 12.50%.The co-infection rate of the two organisms was 6.86%.2.Acute upper respiratory tract infection Streptococcus pneumoniae and Haemophilus influenzae among children attending the clinic were distributed throughout the year,mainly in the second and fourth quarters of each year,with the most positive cases in Guandu District,Kunming City,44.13%and 43.30%,respectively.3.Positive cases generally have fever symptoms,and infection with only Streptococcus pneumoniae is more likely to have elevated C-reactive protein than co-infection with two bacteria,and those infected with Hi and Co-infected with both bacteria are more likely to have clinical symptoms of tonsillar enlargement.4.Positive cases of both Streptococcus pneumoniae and Haemophilus influenzae were mainly concentrated in the 3-to 5-year-old age group,and there was a difference in the positive detection rate between different age groups(χ~2=6.64,P=0.036;χ~2=13.80,P=0.001).5.Streptococcus pneumoniae isolates were 100%resistant to penicillin,erythromycin,tetracycline and clindamycin,28.57%,57.14%,42.86%and 28.57%insensitive to cefotaxime,cotrimoxazole,meropenem and amoxicillin,respectively,and 100%resistant to moxifloxacin,linezolid,vancomycin,chloramphenicol,levofloxacin,teicoplanin and cefepime Sensitivity.6.Haemophilus influenzae had a high resistance rate of 45.45%and 18.18%to ampicillin and azithromycin respectively,and was 100%sensitive to meropenem,chloramphenicol and ceftriaxone.7.1021 children with acute upper respiratory tract infection had 390(38.20%)PCV vaccine;499(48.87%)children had Hib-containing vaccine.Conclusion(s):1.Among children infected with Streptococcus pneumoniae and Haemophilus influenzae in Kunming and its surrounding areas in Yunnan,children in the age group of 3-5 years were susceptible,and both sexes were generally susceptible,with the highest infection rates in the second and fourth quarters.2.The first symptoms of respiratory diseases caused by Streptococcus pneumoniae and Haemophilus influenzae infections are mostly fever,with more pronounced upper respiratory symptoms and generally high blood test results.3.The isolated Streptococcus pneumoniae had high resistance rates to penicillin,erythromycin,tetracycline and clindamycin,but high sensitivity rates to moxifloxacin,rinazolam,vancomycin and chloramphenicol;the isolated Haemophilus influenzae had the lowest sensitivity rate to ampicillin and higher sensitivity rates to chloramphenicol,meropenem and ceftriaxone.4.PCV vaccination rate is lower than that reported in other regions of the country,including Hib vaccination rate is higher than in some areas of China but still lags behind developed countries such as Europe and the United States,and Hi positive cases detected in this region have received Hib vaccine accounted for a relatively large number,which may suggest that Hi infection in this region is dominated by types other than b.5.In this study,samples of upper respiratory tract infection cases were collected from outpatient clinics of a single children’s hospital in Yunnan Province.The next step should be to increase the number of surveillance sentinel sites and expand the surveillance scope to obtain more scientific and comprehensive epidemiological characteristics and serotypes of Streptococcus pneumoniae and Haemophilus influenzae in the region,so as to obtain more comprehensive epidemiological and molecular biological information.