Clinical Characteristics, Antimicrobial Resistance, and Outcomes of Patients with Invasive Pneumococcal Disease in Ningxia Hui Autonomous Region, China, 2013-2021

Jia Tao; Wen Wang; Gang Li; Linlin Wang; Liang Wang; Zhijun Zhao; Wei Jia; Liru Wang

doi:10.1155/2022/1262884

Clinical Characteristics, Antimicrobial Resistance, and Outcomes of Patients with Invasive Pneumococcal Disease in Ningxia Hui Autonomous Region, China, 2013-2021

Can J Infect Dis Med Microbiol. 2022 Dec 12:2022:1262884. doi: 10.1155/2022/1262884. eCollection 2022.

Authors

Jia Tao^{1

2

3}, Wen Wang^{1

2

3}, Gang Li^{1

2

3}, Linlin Wang^{1

2}, Liang Wang^{1

2}, Zhijun Zhao^{1

2

3}, Wei Jia^{1

2

3}, Liru Wang^{1

2

3}

Affiliations

¹ Center of Medical Laboratory, General Hospital of Ningxia Medical University, Yinchuan 750004, China.
² Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan 750004, China.
³ Ningxia Key Laboratory of Clinical and Pathogenic Microbiology, General Hospital of Ningxia Medical University, Yinchuan 750004, China.

Abstract

Objectives: This study aimed to analyze the clinical features, antibiotic susceptibility profiles, and outcomes of patients with invasive pneumococcal disease (IPD) at a hospital in Ningxia Hui Autonomous Region, to provide the basis for improving the clinical treatment effect.

Methods: Patients with IPD were retrospectively collected from 2013 to 2021. Clinical manifestations, laboratory tests, antimicrobial susceptibility, antibiotic treatment, and outcomes of the disease were analyzed.

Results: In this study, we identified 127 IPD cases, of whom 49 (38.6%) had meningitis and 78 (61.4%) had bacteremia. The median ages of pediatric cases and adult cases were 2 years (IQR: 0-5) and 52.5 years (IQR: 35-62), respectively. There were 27 and 45 males in the pediatric and adult groups, and no significant gender difference in the different age groups (p = 0.584) was found. Of 75 cases with underlying diseases, pneumonia (11%), malignancy (11%), hypertension (9.4%), and hepatic cirrhosis (7.9%) were the most common. The incidence of underlying diseases was even higher in the adult group (67.1%) than in the pediatric group (47.1%) (p = 0.028). The frequency of fever, cough, and seizures was significantly higher in the pediatric group than in the adult group, with p-values of 0.004, 0.004, and 0.001, respectively. The percentage of neutrophils in the blood was significantly higher in the adult cases than in the pediatric cases (p < 0.001). Furthermore, there was a significantly higher WBC count (p < 0.001), percentage of neutrophils (p = 0.012), and protein level (p = 0.019) in the CSF samples in the adult patients compared to pediatric patients. The susceptibility rates of S. pneumoniae isolates to vancomycin, linezolid, and levofloxacin were 100%. The susceptibility rates of penicillin were 98.7% and 34.1% in bacteremia and meningitis patients, respectively. Most isolates were resistant to erythromycin, clindamycin, tetracycline, and azithromycin. The most common antibiotic treatment was β-lactams. Seven (5.5%) patients died during hospitalization, and 38 (29.9%) patients' health deteriorated.

Conclusion: These results may provide a reference basis for the diagnosis and empiric treatment of IPD in the region.