Serotype distribution and clinical characteristics associated with streptococcus pneumoniae among Chinese children and adults with invasive pneumococcal disease: a multicenter observational study.

Few studies in China focused on serotypes of Streptococcus pneumoniae in patients with invasive pneumococcal disease (IPD). We aimed at investigating the serotype distribution for IPD-causing S. pneumoniae and vaccine coverage among Chinese children and adults. This was a multicenter, observational study to collect S. pneumoniae isolates from normal sterile sites and IPD-related clinical information among children and adults. Serotyping was performed by a Capsule-Quellung reaction test using type-specific antisera. The study collected a total of 300 eligible isolates (pediatric = 148, adult = 152) were serotyped in a central laboratory. The most prevalent serotypes were 19A (20.9%) and 23 F (20.3%) in the pediatric group; 3 (21.7%) and 19 F (11.8%) in the adult group. PCV10 had low-to-moderate serotype coverage rates for children (60.8%) and adults (34.2%). PCV13 and PPV23 had high coverage rates for children (89.9%, 93.2%) and adults (70.4%, 82.9%), respectively, Investigational PCVs including PCV15 and PCV20 had high estimated coverage rates in children (89.9%, 93.9%). The study identified 269 subjects with IPD reported as the primary diagnosis in the medical records. Sepsis (48/136, 35.3%) and pneumonia (48/133, 36.1%) had the highest occurrence in the pediatric and adult groups, respectively. Study findings showed that non-PCV7 S. pneumoniae 19A and 3 were the most prevalent serotypes in Chinese children and adults, respectively. High-valent vaccines had similar coverage rates and may have a greater potential in preventing IPD.

Pathogens of spontaneous bacterial peritonitis change in northern China.

OBJECTIVE: To determine the identity of microorganisms isolated from patients diagnosed with spontaneous bacterial peritonitis (SBP). METHODS: We reviewed cases diagnosed with SBP over a 14-year period. The medical records of 780 SBP-diagnosed patients with decompensated cirrhosis and ascites admitted to Tangdu Hospital, Xian, Shaanxi Province, China were retrospectively reviewed between January 1996 and December 2009. The patients were placed into 2 groups, and the clinical data were compared between the 2 groups. Ascitic fluid was collected from these patients and cultured for bacteria using the MicroScan WalkAway 40 system. RESULTS: There was a significant difference in the ratio of pathogens between group A (48 patients, from January 1996 to December 2002) and group B (50 patients, from January 2003 to December 2009) (χ²=9.630, p=0.002). The SBP patients with gram-positive bacteria needed significantly more antibiotics within 30 days compared to those with gram-negative bacteria (χ²=12.285, p=0.000). CONCLUSION: In recent years, the types of isolated pathogens have significantly changed in northern China. Such changes have also been observed in other countries and have been attributed to long-term antibiotic therapy and invasive procedures. Changes in the epidemiology of pathogens that cause SBP must be monitored for optimal treatment.