Clinical Analysis Of 424 Children With Pneumococcal Diseases

ObjectiveThe clinical characteristics,drug selection and prognosis of pneumococcal disease in children in our hospital were analyzed retrospectively in order to improve the understanding of pneumococcal disease,better guide the clinical rational medication and improve the prognosis.MethodsThe clinical characteristics,examination and treatment data of 424 children with pneumococcal disease in our hospital from January 1,2018 to December 31,2018 were analyzed retrospectively.Results1.In terms of sex,age and season,424 cases of pneumococcal disease in our hospital were mainly male,accounting for 69.58%.There were 12 cases(2.83%)aged?1 year,312 cases(73.58%)aged 1-3years,88 cases(20.75%)aged 3-6 years,12cases(2.83%)aged ?6 years.Pneumococcal disease were most common in children aged 1-3 years.There were 161 cases in spring,87 cases in summer,54 cases in autumn,and 122 cases in winter,the incidence rate was 37.97%,20.52%,12.74% and28.77%,respectively.Pneumococcal disease occurred mainly in winter and spring.2.There were 372 cases(87.34%)of bronchopneumonia,20 cases(4.72%)of bacteremia,15 cases(3.54%)of bronchitis,12 cases(2.83%)of meningitis,3 cases(0.71%)of suppurative otitis media,2 cases(0.47%)of empyema.3.The positive rate of sputum specimens was the highest among all the streptococcus pneumoniae isolates,accounting for 86.08%(354 strains),followed by alveolar lavage fluid(22 cases,5.19%),blood(20 cases,4.72%),cerebrospinal fluid(12 cases,2.83%),ear secretion(3 cases,0.71%)and pleural fluid(2 cases,0.47%).4.In co-infection with other pathogens,there were 248 cases(58.49%)of co-infection,which was more than single infection,and 133 cases(53.63%)ofco-infection with human respiratory syncytial virus,and the most of co-infection with atypical pathogens was mycoplasma pneumoniae,accounting for 18.95%.5.In the drug sensitivity test,Streptococcus pneumoniae strains were 100%sensitive to Levofloxacin,Vancomycin,Linezolid,Teicoplanin and Rifampicin.The susceptibility rates of streptococcus pneumoniae strains to penicillin and cefotaxime sodium were 95.31%(386/405)and 87.83%(361/411),respectively.The susceptibility rates of streptococcus pneumoniae strains to penicillin and cefotaxime sodium were 58.33%(7/12)and 91.67%(11/12),respectively.The resistance rates of streptococcus pneumoniae strains to Erythromycin,Lincomycin,Tetracycline and Neoforman were 58.33% and 91.67%,respectively,their drug resistance rates were98.08%(408/416),95.19%(396/416),84.05%(353/420)and 76.37%(320/419)respectively.6.Clinical Antimicrobial Drug Selection,Patients with streptococcus pneumoniae infection who had experienced antibiotic selection prior to laboratory test results were compared with 341 patients who had experienced drug sensitivity,the anastomotic rate was 80.42%.Only 83 cases(19.58%)were changed according to the result of drug sensitivity.7.In the treatment outcome,1 case died(0.24%),the rest were cured,The average hospitalization time of single infection and mixed infection was 8.13±4.82 days and 8.36±5.54 days,respectively.The hospitalization time of mixed infection was longer than that of single infection.There was no significant difference between the two groups(t=0.451,p=0.652).Conclusions1.The most common pneumococcal disease in children is 1-3 years old,with a high incidence in spring and winter.Bronchopneumonia is the most common infectious disease in children with Pneumococcal disease.2.The most common pathogens associated with pneumococcal disease were human respiratory syncytial virus,and the most common mixed atypical pathogens were mycoplasma pneumoniae.3.Streptococcus pneumoniae strains were high sensitive to Levofloxacin,Vancomycin,Linezolid,Penicillin and Cefotaxime sodium,but high resistant to Erythromycin.4.The results of clinical experience in treatment were in good agreement with those of drug sensitivity test in laboratory.In clinical treatment,we can select drugs as early as possible so as to improve the curative effect.5.Mixed infection may be more likely to prolong the length of hospital stay,the prognosis is worse than a single infection.