Pediatrics · 2026
Pneumococcal Pneumonia in Hospitalized Children: 2017-2023.
СтатьяНазвание и аннотация: Перевод в очереди
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Engstrom Eric E, Kaplan Sheldon L, Barson William J, Lin Philana Ling, Dahl Steven, Bradley John S, Pannaraj Pia S, Tan Tina Q, Dien Bard Jennifer, Ramirez Kacy, Grant Lindsay R, Arguedas Adriano, Tort Maria J, Miller Ashley, Cané Alejandro, Hulten Kristina G
Аннотация
OBJECTIVES: We hypothesized that the incidence, clinical presentation, isolate serotypes, and isolate antibiotic susceptibility of Streptococcus pneumoniae causing pneumonia in children varied before and through the course of the COVID-19 pandemic.
METHODS: Patients aged 18 years or younger at 8 children's hospitals in the United States admitted with culture-positive pneumonia were identified. Serotyping of pneumococcal isolates was performed at a central research laboratory. Clinical and laboratory data were collected retrospectively with a standardized case report form.
RESULTS: We identified 190 patients with pneumococcal pneumonia from 2017 to 2023. Cases decreased significantly in 2020 (P < .05), with a surge in 2022 and 2023. Serotype 3 was the most common serotype, was prominent after 2021, and was associated with a significantly higher rate of empyema and necrotizing parenchyma (P < .001). PCV13 serotypes 3, 19A, and 19F constituted over half of isolates; new serotypes in PCV15 (22F and 33F) and PCV20 (8, 10A, 11A, 12F, 15B, 22F, and 33F) accounted for 14% and 22% of isolates, respectively. Penicillin susceptibility (minimum inhibitory concentration [MIC] ≤ 2 μg/mL) was very common (94% of isolates), and all 11 isolates with MIC greater than 2 μg/mL were serotype 19A. Of those tested, 90 patients had viral coinfections; only influenza was associated with more pneumonia complications compared with patients without influenza (P = .002).
CONCLUSIONS: S pneumoniae remains an important cause of pneumonia in children with the potential for severe infections. After 2020, increasing rates have primarily been due to serotype 3, while β-lactam resistance was largely associated with serotype 19A. PCV15 and PCV20 may modestly reduce pneumococcal pneumonia incidence further.
METHODS: Patients aged 18 years or younger at 8 children's hospitals in the United States admitted with culture-positive pneumonia were identified. Serotyping of pneumococcal isolates was performed at a central research laboratory. Clinical and laboratory data were collected retrospectively with a standardized case report form.
RESULTS: We identified 190 patients with pneumococcal pneumonia from 2017 to 2023. Cases decreased significantly in 2020 (P < .05), with a surge in 2022 and 2023. Serotype 3 was the most common serotype, was prominent after 2021, and was associated with a significantly higher rate of empyema and necrotizing parenchyma (P < .001). PCV13 serotypes 3, 19A, and 19F constituted over half of isolates; new serotypes in PCV15 (22F and 33F) and PCV20 (8, 10A, 11A, 12F, 15B, 22F, and 33F) accounted for 14% and 22% of isolates, respectively. Penicillin susceptibility (minimum inhibitory concentration [MIC] ≤ 2 μg/mL) was very common (94% of isolates), and all 11 isolates with MIC greater than 2 μg/mL were serotype 19A. Of those tested, 90 patients had viral coinfections; only influenza was associated with more pneumonia complications compared with patients without influenza (P = .002).
CONCLUSIONS: S pneumoniae remains an important cause of pneumonia in children with the potential for severe infections. After 2020, increasing rates have primarily been due to serotype 3, while β-lactam resistance was largely associated with serotype 19A. PCV15 and PCV20 may modestly reduce pneumococcal pneumonia incidence further.