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

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.

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Publication Details

Journal
Pneumonia
Published
2024-11-24
DOI
https://doi.org/10.1186/s41479-024-00151-x
Citations
4
Primary Topic
Pneumonia and Respiratory Infections
Type
article
Field-Weighted Citation Impact
1.55

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article

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

Catarina Gouveia, Florbela Cunha, Catarina Chaves, Paulo Lopes et al.
4 citations
Pneumonia
Pneumonia and Respiratory Infections
1.55
article

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

Catarina Gouveia, Florbela Cunha, Catarina Chaves, Paulo Lopes, Rui Ferreira, Cristina dos Santos Ferreira, Elsa Calado, Ana Jesus, Jesuína Duarte, Isabel Peres, Cristina Didelet, Manuela Azevedo, Margarida Monteiro, Maria Paula Falcão, Mónica Rebelo, Sónia Ferreira, Manuela Costa Alves, Sandra I. Vieira, Joana Bernardo, Cristina Resende, Cristina Faria, Eurico Gaspar, Hugo Cruz, Maria José Dinis, Maria José Rego de Sousa, Fernanda Rodrigues, Adriana Pedrosa, Sofia Marques, Isabel Brito, Luísa Gonçalves, Ana Friães, Paula Correia, Gabriela de Azevedo Abreu, Gina Marrão, Graça Seves, Cristina Bragança, Clara Portugal, Manuel Cunha, Maria Ana Pessanha, Inês Roxo, Maria João Virtuoso, Aurélia Selaru, Rita Belo Morais, Maria Favila Menezes, Miguel Tomás Vila, Lino Marques, Margarida Tomaz, Filipa Vicente, Isabel Carvalho, Vitória Eduarda Silva Rodrigues, Cristina Marcelo, Cláudia Fidalgo, Odete Chantre, Margarida Tavares, Raquel Diaz, Manuela Ferreira, Patrícia Pereira, Cláudia Ferreira, Francisca Lopes, Estela Veiga, Jacinta Moreira, Maria Manuel Zarcos, Fátima L. S. Nunes, Rosário Massa, Alberta Faustino, Margarida Guedes, Cristina Mota Preto, Carla Ferreira, Isabel Vale, Maria Calle, Ana P. Teixeira, P. Carvalho, Maria Ana Sampaio Nunes, Pedro Flores, Nancy Guerreiro, Filipa Marcelo, Carla Cruz, João Gaspar Marques, Ana Aguiar, Henrique Oliveira, Ângela Castro Resende, Teresa Casas, Nadiya Kruptsala, Leonardo Carneiro, João Faria, Francesca Fortunato, Sónia Aires, Bernardo Camacho, Marília Gião, Paula Pestana, Margarida Pinto, Antonio Huertas Salgado, Margarida Fardilha, Filomena Pereira, Fernanda G. Pereira, Marcos D. Pinho, Joana Gomes‐Silva, Ana Luísa Teixeira, Dora Gomes, Patrícia Amantegui, José Melo‐Cristino, Sofia A. Costa Lima, Mário Ramirez, Elisabete Cristovam, Sílvia Almeida, Celeste Pontes, Joana Selada, Margarida Pereira, Susana Sampaio, Catarina Silva‐Costa, Angelina Lameirão, Cristina Toscano, Rui Semedo, Teresa Reis, Miguel Seruca, Natália Novais, Ilse Fontes, Sofia Arosa, Mariana Silva, Maria Fátima Silva, Alexandra Costa, Rui Tomé Ribeiro, Maria Cármen Iglesias, Carla Leite, Filipa Silva, Joaquim Cunha, Hugo Loureiro, Sara Santos, Nádia Martins, Luís Martins, Helena Gonçalves, Cláudia Dias Monteiro Toma, Sofia Fraga, José Mota Freitas, Virgínia Lopes, Isabel Lourenço, Isabel Monteiro, Elsa Gonçalves, Fernando Fonseca, Ana Paula Castro, Teresa Tomé, Ana Cristina Braga, Filipa Prata, Marta Nicolau, Álvaro Sousa, Hermínia Costa, Céu Novais, Ana Paula Mota Vieira, Sandra Schäfer, Luís Lito, Luísa Oliveira, Marta Cabral, Manuela Ribeiro, Gustavo Rodrigues, Teresa Morais, Andreia Bernardo, Hugo Rodrigues, Ana Maria Henriques Correia, José Diogo, Maria Antónia Read, Maria Amélia Afonso, Manuela Brandão, João Calado Nunes, Isabel Daniel, María Raquel Lucas, Luísa Boaventura, Luís Gonçalves, Marvin Oliveira, Elzara Aliyeva, Bruno Miguel, Adriana Coutinho, Marisa Vieira, Ana Bruschy Fonseca, Mariana Bettencourt Viana, Vasco Mendes, Hugo Antunes Macedo, J. Lorenzo Franco, Valquíria Alves, José Manuel Carvalho Marta, Ezequiel Moreira, Adília Vicente, Isabel Monge, Inês Tapadinhas, Susana Banza, Marisol Lourinha, Agostinho Fenandes
article en
4 citations

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.

PneumoniaVol. 16(1)
University of Lisbon (PT), Universidade Politécnica de Castelo Branco (PT), Hospital Center of Cova da Beira (PT), Nanium (Portugal) (PT), Unidade Local de Saúde de Entre Douro e Vouga (PT), Agencia Regional da Energia e Ambiente da Regiao Autonoma da Madeira (PT), Escola Superior de Saúde da Cruz Vermelha Portuguesa (PT), Instituto de Medicina Tropical (PY), Universidade Politécnica da Guarda (PT), Lusíada University of Lisbon (PT), Administração Regional de Saúde de Lisboa e Vale do Tejo (PT), IPO Porto (PT), Hospital do Divino Espírito Santo (PT), Algarve Biomedical Center (PT), Centro Hospitalar do Tâmega e Sousa (PT), Centro Hospitalar de Lisboa Ocidental (PT), Celulose Beira Industrial (Portugal) (PT), Hospital da Luz (PT), Paralab (Portugal) (PT), Centro Hospitalar de Vila Nova de Gaia (PT), Câmara Municipal de Almada (PT), Hospital de Santo Espirito de Angra do Heroísmo (PT), Escola Secundária de Loulé (PT), Unidade Hospitalar de Bragança (PT), Hospital do Desterro (PT), Centro Hospitalar do Baixo Vouga (PT), Regional Government of Madeira (PT), Hospital CUF Descobertas
Pfizer
Good health and well-being
Openalex Percentile: Top 15%
Pneumonia and Respiratory Infections
1.55
DOIOpen Access PDFOpenAlex
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