Objective: To probe into the clinical characteristics and bacterial drug resistance of children with invasive pneumococcal disease (IPD) in the Children’s Hospital Affiliated to Zhengzhou University

so as to provide reference for clinical diagnosis and treatment of IPD and rational drug use. Methods: Streptococcus pneumoniae isolated from sterile site specimens (blood

cerebrospinal fluid

joint effusion

bone marrow fluid and pleural effusion) in hospitalized children of our hospital from Mar. 2015 to Mar. 2020 were retrospectively analyzed. A total of 138 children with 159 strains of pathogenic bacteria were enrolled. General information such as gender

age

type of infection

underlying disease and the results of drug resistance testing of isolated strains were analyzed. Results: Among the 138 children

86 cases were males and 52 cases were females

the male-to-female ratio was 1.65∶1

with age ranged from 1 d to 13 years

the median age was 1 year and 2 months

125 cases (90.6%) were <5 years old. The clinical types included 41 cases of meningitis (29.7%)

46 cases (33.3%) of bacteremic pneumonia and 35 cases (25.4%) of non-focused bloodstream infection. Fever was the first symptom in 98.55% of children

underlying diseases were found in 34 cases (24.6%). The insensitivity rates of meningitis and non-meningitis strains to penicillin were respectively 66.67% (22/33) and 7.94% (10/126)

with statistically significant difference (P<0.01). Compared with the non-pneumococcal meningitis group

there were statistically significant differences in the percentage of peripheral blood neutrophils

C-reactive protein (CRP)

procalcitonin (PCT)

cerebrospinal fluid white blood cell count and cerebrospinal fluid protein in the pneumococcal meningitis group (P<0.05). Result of follow-up showed that 17 cases died (12.3%). Conclusion: Most of the IPD diagnosed in pediatrics of our hospital are children with community infection under 2 years old

and most of them have a history of ICU residence and mechanical ventilation. Most of the deaths are children with meningitis infection. IPD pathogenic bacteria are highly resistant to penicillin. The resistance rate of penicillin isolates of S. pneumoniae is higher than that of non-meningitis. Clinical diagnosis and treatment should focus on prevention and control

timely inspection and rational use of antibiotics