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Clinical characteristics and serotype distribution of invasive pneumococcal disease in pediatric patients from Beijing, China

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Abstract

Invasive pneumococcal disease (IPD) is associated with significant morbidity and mortality. However, limited studies have reported clinical features of IPD cases among Chinese children. This study aimed to evaluate clinical characteristics as well as serotype distribution of hospitalized IPD children in Beijing, China. Children with confirmed IPD were retrospectively recruited from January 2014 to December 2019. Clinical data were gathered from medical records, and serotypes of Streptococcus pneumoniae isolates were detected. Clinical differences between deaths and survivors were also compared, and risk factors associated with death were determined. Of sixty-eight children diagnosed with IPD, 58 (85.3%) were < 5 years. 19F was the predominant serotype (23, 33.8%), followed by 19A (14, 20.6%), 14 (12, 17.6%), 23F (5, 7.4%), and non-vaccine serotype (NVT) 15A (3, 4.4%). The coverage rate of 13-valent pneumococcal conjugate vaccine (PCV) was 92.6% (63). After introduction of PCV-13, there was a significant increase of IPD due to NVTs (p = 0.047). Sixteen (23.5%) children died, and diagnoses of 11 (68.8%) were meningitis. Risk factors for death were < 2 years (odds ratio [OR] [95% confidence interval {CI}]: 6.64 [1.14–32.10]; p = 0.019), altered mental status (OR [95%CI]: 10.10 [2.11–48.31]; p = 0.004), and septic shock (OR [95%CI]: 6.61 [1.11–39.50]; p = 0.038). This study revealed that the case fatality rate of hospitalized IPD children was high in this hospital. Fatal cases were more likely to be children < 2 years, presented with changed mental status and septic shock. Notably, we found that NVTs increased after PCV13 availability in China.

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Availability of data and material

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

Funding

This work was supported by the National Natural Science Foundation of China (81378153) and the Chinese Academy of Medical Sciences (2019RU016). The funders had no role in study design, data collection and analysis, preparation of the manuscript, or decision to publish.

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Authors and Affiliations

  1. Pediatric Intensive Care Unit, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No.56 Nan-Li-Shi Road, Beijing, 100045, China

    Yan Xu, Kechun Li, Yingchao Liu & Suyun Qian

  2. Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, China

    Qing Wang, Kaihu Yao, Wei Shi & Yue Li

  3. Bacteriology Laboratory, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, China

    Fang Dong & Wenqi Song

  4. Department of Infectious Diseases, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, China

    Gang Liu

  5. Department of Respiratory, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, China

    Baoping Xu

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  1. Yan Xu
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  2. Qing Wang
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Contributions

Conceptualization: Suyun Qian. Methodology: Yan Xu, Qing Wang, Wei Shi, Yue Li. Formal analysis and investigation: Yan Xu. Writing—original draft preparation: Yan Xu. Writing—review and editing: Suyun Qian, Kaihu Yao, Fang Dong, Wenqi Song, Gang Liu, Baoping Xu. Funding acquisition: Kaihu Yao, Suyun Qian. Resources: Yan Xu, Kechun Li, Yingchao Liu. Supervision: Kaihu Yao, Suyun Qian, Fang Dong, Wenqi Song, Gang Liu, Baoping Xu.

Corresponding author

Correspondence to Suyun Qian.

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Ethics approval

This study was reviewed and approved by the Ethics Committee of Beijing Children’s Hospital affiliated to Capital Medical University.

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The applications for the exemption of written informed content and ethical review were approved by the Ethics Committee of Beijing Children’s Hospital Affiliated to Capital Medical University according to national regulations (No. 2016–93, 23/06/2016). Verbal consent was obtained from the parents or legal guardians of the patients.

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Comparison of clinical variables between invasive pneumococcal disease patients admitted in the pre- (2014–2016) and post- (2017–2019) PCV13 periods (DOCX 23 kb)

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Xu, Y., Wang, Q., Yao, K. et al. Clinical characteristics and serotype distribution of invasive pneumococcal disease in pediatric patients from Beijing, China. Eur J Clin Microbiol Infect Dis 40, 1833–1842 (2021). https://doi.org/10.1007/s10096-021-04238-x

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