Serotype distribution of<i>Streptococcus pneumoniae</i>and potential impact of pneumococcal conjugate vaccines in China: A systematic review and meta-analysis

Chen, Kaile; Zhang, Xiyan; Shan, Wei; Zhang, Tao

doi:10.1080/21645515.2018.1435224

Cited by 32 publications

(20 citation statements)

References 38 publications

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“…The positive rate of S.pneumoniae was much lower than that of M. pneumoniae, which was different from the previous understanding[6][7]. It may be associated with the application of S.pneumoniae vaccines in China, which can prevent the occurence of S.pneumoniae infection[21][22][23][24].The misuse of antibiotics was common in the nation, which can also bring down the infection of S.pneumoniae. The microbial cultivation can bring false negative results in some samples.…”

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confidence: 69%

Epidemiology and clinical characteristics of pathogens responsible for the hospitalization of children with segmental/lobar pattern pneumonia

Wang

et al. 2019

Preprint

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Backgrounds: The occurrence of segmental/lobar pattern pneumonia (S/L-PP) in children has recently increased. The pathogens of the disease may change due to the misuse of antibiotics and the application of vaccines. Therefore, pathogens of S/L-PP in hospitalized children and their association with clinical characteristics may have changed. Objective: To analyze the pathogens of S/L-PP in hospitalized children and their association with clinical characteristics. Methods: The current study analyzed the epidemiological and clinical characteristics of pathogens in children with S/L-PP under 14 years old at a single hospital between 1 st Jan 2014 and 31 st Dec 2018 retrospectively. The pathogens were detected by microbial cultivation, and/or indirect immunofluorescence of the kit (PNEUMOSLIDE IgM), and/or ELISA, and/or realtime PCR in the samples of the patients. Results: A total of 593 children with S/L-PP received treatment at a single hospital during the study period by inclusion criteria. 451 (76.05%) patients were single positive for one pathogen and 83 (14.00%) patients had multiple infections. Mycoplasma pneumoniae ( M.pneumoniae ) (72.34%) was the most frequently identified pathogen, followed by Streptococcus pneumoniae ( S.pneumoniae ) (8.77%). The infection of M.pneumoniae in children with S/L-PP increased with time (p<0.05). The positive rate of M.pneumoniae increased with ages of patients (p<0.05). M.pneumoniae was statistically associated with extrapulmonary manifestations while S.pneumoniae was statistically associated with abnormal white blood cells (WBCs) and C reactive proteins (CRPs) (p<0.05). Conclusion: M.pneumoniae was the most frequently identified pathogen in children with S/L-PP. The positive rate of M.pneumoniae in children with S/L-PP increased with time and the ages of children. M.pneumoniae was associated with extrapulmonary manifestations while S.pneumoniae was associated with abnormal WBCs and CRPs.

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confidence: 69%

Epidemiology and clinical characteristics of pathogens responsible for the hospitalization of children with segmental/lobar pattern pneumonia

Wang

et al. 2019

Preprint

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“…The positive rate of S.pneumoniae was much lower than that of M. pneumoniae, which was different from the previous understanding [6][7]. It was associated with the wide application of S.pneumoniae vaccines in China, which can prohibit the prevalence of S.pneumoniae infection [21][22][23][24]. The abuse of antibiotics was common in the nation, which can also bring down the infection of S.pneumoniae.…”

mentioning

confidence: 74%

Epidemiology and clinical characteristics of pathogens responsible for the hospitalization of children with segmental/lobar pattern pneumonia

Wang

et al. 2019

Preprint

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Backgrounds The occurrence of segmental/lobar pattern pneumonia (S/L-PP) in children increases with years. The pathogens of the disease may change for the abuse of antibiotics and the application of vaccines. Therefore, pathogens of S/L-PP in hospitalized children and their association with clinical characteristics may have changed. Objective: To analyze the pathogens of S/L-PP in hospitalized children and their association with clinical characteristics. Methods: The current study analyzed the epidemiological and clinical characteristics of pathogens in children with S/L-PP at a single hospital between 1st Jan 2014 and 31st Dec 2018 retrospectively. The pathogens and their associations with clinical characteristics were statistically analyzed. Results: A total of 593 children with S/L-PP received treatment at a single hospital during the study period by inclusion criteria. 451 patients were single positive for one pathogen and 83 patients had multiple infections. Mycoplasma pneumoniae (M.pneumoniae) (72.34%) was the most commonly detected pathogen, followed by streptococcus pneumoniae (S.pneumoniae) (8.77%). The infection of M.pneumoniae in children with S/L-PP increased with years (p<0.05). The positive rate of M.pneumoniae increased with ages of patients (p<0.05). M.pneumoniae was statistically associated to the extrapulmonary manifestations while S.pneumoniae was statistically associated with abnormal white blood cells (WBCs) and C reactive proteins (CRPs) (p<0.05). Conclusion: M.pneumoniae was the most positive pathogen in children with S/L-PP. The positive rate of M.pneumoniae in children with S/L-PP increased with years and the ages of children. M.pneumoniae was associated with extrapulmonary manifestations while S.pneumoniae was associated with abnormal WBCs and CRPs.

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“…One major cause for more widespread carbapenem resistance in our study may be the lower number of patients having received the pneumococcal conjugate vaccine (PCV). Studies have demonstrated that the introduction of PCV reduces the prevalence of vaccine-type drug-resistant S. pneumoniae (20)(21)(22)(23). Since PCV is not a routine vaccination for Chinese children, the PVC vaccination rate in China (21) is much lower than that in developed counties (22,23).…”

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confidence: 99%

Effects of Delayed Antibiotic Therapy on Outcomes in Children with Streptococcus pneumoniae Sepsis

Cheng

et al. 2019

Antimicrob Agents Chemother

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Delayed antimicrobial therapy is associated with poor outcomes in sepsis, but the optimal antibiotic administration time remains unclear. We aimed to investigate the effects of the time of antimicrobial administration on outcomes and evaluate an optimal empirical antibiotic administration time window for children with Streptococcus pneumoniae sepsis. This retrospective study enrolled children with S. pneumoniae sepsis who presented to the Children’s Hospital of Chongqing Medical University from May 2011 to December 2018. Classification and regression tree (CART) analysis was used to determine the time-to-appropriate-therapy (TTAT) breakpoint. Outcomes were compared between patients receiving early or delayed therapy, defined by CART-derived TTAT breakpoint. During the study period, 172 patients were included. The CART-derived TTAT breakpoint was 13.6 h. After adjustment for confounding factors, a TTAT of ≥13.6 hours was found to be an independent predictor of sepsis-related in-hospital mortality (odds ratio [OR] = 39.26; 95% confidence interval [CI] = 6.10 to 252.60), septic shock (OR = 4.58; 95% CI = 1.89 to 11.14), and requiring mechanical ventilation (OR = 2.70; 95% CI = 1.01 to 7.35). A Pediatric Risk of Mortality (PRISM) III score of ≥10 was independently associated with delayed therapy. Delayed antibiotic therapy was associated with poor outcomes in children with S. pneumoniae sepsis. The optimal empirical antibiotic administration time window in children with S. pneumoniae sepsis was within 13.6 h. Efforts should be made to ensure timely and appropriate therapy.

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Serotype distribution ofStreptococcus pneumoniaeand potential impact of pneumococcal conjugate vaccines in China: A systematic review and meta-analysis

Abstract: The most common pneumococcal serotype in mainland China was 19F. The serotype coverage rates of PCV13 and PPSV23 were 50%-68% in mainland China.

Cited by 32 publications

References 38 publications

Epidemiology and clinical characteristics of pathogens responsible for the hospitalization of children with segmental/lobar pattern pneumonia

Epidemiology and clinical characteristics of pathogens responsible for the hospitalization of children with segmental/lobar pattern pneumonia

Epidemiology and clinical characteristics of pathogens responsible for the hospitalization of children with segmental/lobar pattern pneumonia

Effects of Delayed Antibiotic Therapy on Outcomes in Children with Streptococcus pneumoniae Sepsis

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