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Multicenter Study
. 2019 Jun;98(24):e15942.
doi: 10.1097/MD.0000000000015942.

Antibiotic resistance profiles and multidrug resistance patterns of Streptococcus pneumoniae in pediatrics: A multicenter retrospective study in mainland China

Cai-Yun Wang  1 , Ying-Hu Chen  1 , Chao Fang  2 , Ming-Ming Zhou  2 , Hong-Mei Xu  1 , Chun-Mei Jing  3 , Hui-Ling Deng  4 , Hui-Jun Cai  5 , Kai Jia  5 , Shu-Zhen Han  4 , Hui Yu  4 , Ai-Min Wang  6 , Dan-Dan Yin  6 , Chuan-Qing Wang  6 , Wei Wang  1 , Wei-Chun Huang  7 , Ji-Kui Deng  8 , Rui-Zhen Zhao  8 , Yi-Ping Chen  1 , Ji-Hong Yang  9 , Chun Wang  10 , Yan-Ran Che  11 , Xiu-Zhen Nie  1 , Shi-Fu Wang  12 , Jian-Hua Hao  1 , Cong-Hui Zhang  13
Affiliations
Multicenter Study

Antibiotic resistance profiles and multidrug resistance patterns of Streptococcus pneumoniae in pediatrics: A multicenter retrospective study in mainland China

Cai-Yun Wang et al. Medicine (Baltimore). 2019 Jun.

Abstract

Emergent resistance to antibiotics among Streptococcus pneumoniae isolates is a severe problem worldwide. Antibiotic resistance profiles for S pneumoniae isolates identified from pediatric patients in mainland China remains to be established.The clinical features, antimicrobial resistance, and multidrug resistance patterns of S pneumoniae were retrospectively analyzed at 10 children's hospitals in mainland China in 2016.Among the collected 6132 S pneumoniae isolates, pneumococcal diseases mainly occurred in children younger than 5 years old (85.1%). The resistance rate of S pneumoniae to clindamycin, erythromycin, tetracycline, and trimethoprim/sulfamethoxazole was 95.8%, 95.2%, 93.6%, and 66.7%, respectively. The resistance rates of S pneumoniae to penicillin were 86.9% and 1.4% in non-meningitis and meningitis isolates, while the proportions of ceftriaxone resistance were 8.2% and 18.1%, respectively. Pneumococcal conjugate vaccine was administered to only 4.1% of patients. Penicillin and ceftriaxone resistance, underling diseases, antibiotic resistant risk factors, and poor prognosis appeared more frequently in invasive pneumococcal diseases. The incidence of multidrug resistance (MDR) was 46.1% in patients with invasive pneumococcal disease which was more than in patients with non-invasive pneumococcal disease (18.3%). Patients with invasive pneumococcal disease usually have several MDR coexistence.S pneumoniae isolates showed high resistance to common antibiotics in mainland China. Penicillin and ceftriaxone resistance rate of invasive streptococcal pneumonia patients were significantly higher than that of non-invasive S pneumoniae patients. Alarmingly, 46.1% of invasive clinical isolates were multidrug resistant, so it is important to continued monitor the resistance of S pneumoniae when protein conjugate vaccine (PCV13) is coming in mainland China.

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Conflict of interest statement

No potential conflicts of interest to declare.

Figures

Figure 1
Figure 1
Age and seasonal distribution among clinical specimens. A. Proportion and age distribution of S pneumoniae isolates collected from different specimen sources. B. Proportion and seasonal distribution of S pneumoniae isolates collected from different specimen sources. C. Antibiotic susceptibility of S pneumoniae isolates. D. Comparison of antibiotic resistance between patients ≤5 years and patients >5 years. ∗P < .05. An asterisk indicates a statistically significant difference between time periods (P < .05).
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