Streptococcus pneumoniae Remains Leading Cause of Bacteremia in Children Despite 13-Valent Pneumococcal Conjugate Vaccine Introduction.

AIM: To describe the epidemiology and primary diagnoses of previously healthy children aged 3-59 months who presented to paediatric emergency departments (PEDs) with a positive blood culture following the introduction of the publicly funded 13-valent pneumococcal conjugate vaccine (PCV13).

METHODS

We conducted a multicentre, cross-sectional, retrospective registry study in seven PEDs between 2017 and 2022. The findings were compared with those of a similar registry from 2011 to 2016.

RESULTS

During the funded PCV13 period, 278 patients were recorded. The most frequently isolated bacteria were Streptococcus pneumoniae (36.6%), Escherichia coli (12.6%), and Streptococcus pyogenes (9.4%) [Correction added on 7 August 2025, after first online publication: The percentage for Streptococcus pyogenes was corrected from (29.4%) to (9.4%).]. The most common diagnosis was focal infection (54.3%), followed by bacteremia without a focus of infection (26.6%), and severe invasive bacterial infection (19.1%). Poor outcomes were observed in 29.8% of patients. The most common serotypes during the funded PCV13 period were 10A, 24, and 8, none of which are included in PCV13.

CONCLUSIONS

Streptococcus pneumoniae remained the leading cause of bacteremia in previously healthy children aged 3-59 months, with a predominance of non-vaccine serotypes. Although half of the patients had a localised infection, a substantial proportion developed severe invasive bacterial infections. Poor outcomes occurred in one out of every three to four invasive bacterial infections.