Invasive Pneumococcal Disease in Children: A Case Series on Clinical Profile, Serotypes and Antibiotic Resistance from Southern India

Invasive Pneumococcal Disease (IPD) is defined as the isolation of pneumococci from normally sterile sites, including blood, cerebrospinal fluid, pleural fluid, ascitic fluid and synovial fluid. Despite widespread vaccination, IPD continues to be a major public health concern worldwide. Studying antibiotic resistance in the context of emerging serotypes and vaccines for IPD is crucial for optimising clinical management, guiding vaccine strategies and forming public health policies. By understanding the interplay between serotype dynamics, antibiotic resistance and vaccination, researchers and healthcare professionals can better mitigate the impact of pneumococcal disease on global health. In this case series, the authors describe the clinical profile, serotypes and antibiotic resistance of five cases of IPD in the paediatric age group. All five children exhibited severe signs of IPD, such as meningitis or septicaemia. The serotypes identified were 15C (2 cases), 6B, 19F and 23F. All five cases were sensitive to chloramphenicol, vancomycin, linezolid and levofloxacin. All cases were resistant to penicillin, and only one case was sensitive to erythromycin; all others were resistant. Cefotaxime was sensitive in three cases and intermediate in two cases. Cotrimoxazole was resistant in three cases, sensitive in one and intermediate in another case. The currently available Pneumococcal Conjugate Vaccine (PCV) offer substantial protection against IPD, but the occurrence of severe IPD cases, such as meningitis and septicaemia, necessitates the introduction of newer vaccines with broader coverage, such as PCV 15 and PCV 20.