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. 2024 Nov 25;16(1):26.
doi: 10.1186/s41479-024-00151-x.

Pneumococci remain the main cause of complicated pediatric pneumonia in the post-pandemic era despite extensive pneumococcal vaccine use

Joana Gomes-Silva  1 , Marcos D Pinho  1 , Ana Friães  1 , Mário Ramirez  2 , José Melo-Cristino  1 , Catarina Silva-Costa  1 ; Portuguese Group for the Study of Streptococcal Infections; Portuguese Study Group of Invasive Pneumococcal Disease of the Pediatric Infectious Disease Society
Collaborators, Affiliations

Pneumococci remain the main cause of complicated pediatric pneumonia in the post-pandemic era despite extensive pneumococcal vaccine use

Joana Gomes-Silva et al. Pneumonia (Nathan). .

Erratum in

Abstract

Nucleic acid amplification tests (NAATs) greatly enhance the capacity to identify the etiology of pediatric complicated pneumonia. However, the use of pneumococcal conjugate vaccines could reduce the importance of Streptococcus pneumoniae in pediatric complicated pneumonia with the potential emergence of other bacterial agents. Using an expanded NAAT in culture negative pleural fluid or empyema samples collected in 2010-2024 (n = 554) in Portugal, we show that S. pneumoniae remains the most frequent agent despite decades of pneumococcal conjugate vaccine use and the COVID-19 pandemic. A rebound in pediatric complicated pneumonia occurred post-pandemic, including a rise in cases by Streptococcus pyogenes and Haemophilus influenzae. Empiric therapy of pediatric complicated pneumonia should still consider S. pneumoniae as the most likely cause, even in countries where the pneumococcal conjugate vaccine is in the national immunization program with a high uptake.

Keywords: Empyema; Epidemiology; Molecular Diagnostics; Pediatric infectious disease; Serotypes; Streptococcus pneumonia; Vaccines.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: No personal and sensitive data was collected. The data collected is anonymous data, i.e., the identity of the person to whom the data are referred to was unknown. The patient samples are collected within the context of the diagnostic workup at the discretion of the attending physician and no specific guidelines or recommendations are in force because of the study. The study was approved by the Institutional Review Board of the Centro Académico de Medicina de Lisboa (240/22). Since these were considered surveillance activities they were exempt from informed consent. Consent for publication: Not applicable. Competing interests: JM-C received research grants administered through his university and received honoraria for serving on the speakers bureaus of Pfizer and Merck Sharp and Dohme. MR received honoraria for serving on the speakers bureau of Pfizer and Merck Sharp and Dohme, for serving in expert panels of Merck Sharp and Dohme, support for attending meetings from Pfizer, and received research grants administered through his university from Merck Sharp and Dohme. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
Number of samples from pediatric patients (< 18 years) indicating any identified pathogens (Portugal, 2009/10 – 2023/24)
See this image and copyright information in PMC

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