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Published on: September 11, 2020
Pneumococcal necrotizing pneumonia in Utah: does serotype matter?
Jeffrey M Bender1, Krow Ampofo, Kent Korgenski
1Department of Pediatrics, Division of Infectious Diseases, University of Utah, USA. Jeffrey.Bender@hsc.utah.edu
Summary
Pediatric pneumococcal necrotizing pneumonia (PNP) is rising, particularly with non-vaccine serotypes. Serotype 3 significantly increases the risk of developing severe PNP in children.
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
- Vaccinology
Background:
- Streptococcus pneumoniae is a leading cause of pediatric pneumonia.
- The incidence of pneumococcal necrotizing pneumonia (PNP) has increased despite vaccination.
- This study investigates temporal trends and serotype associations of PNP in Utah.
Purpose of the Study:
- To describe temporal trends in pediatric pneumococcal necrotizing pneumonia (PNP).
- To identify pneumococcal serotypes associated with PNP.
- To inform future vaccine strategies.
Main Methods:
- Retrospective review of children (<18 years) with S. pneumoniae positive cultures and pneumonia.
- Analysis of radiographic evidence of PNP from January 1997 to March 2006.
- Serotyping of all S. pneumoniae isolates.
Main Results:
- PNP occurred in 27% of 124 pediatric pneumococcal pneumonia cases.
- PNP incidence increased from 13% (1997-2000) to 33% (2001-2006).
- Non-vaccine serotypes rose from 49% to 88%; Serotype 3 was strongly associated with PNP (OR, 14.67).
Conclusions:
- PNP is an increasing complication of pediatric S. pneumoniae pneumonia.
- Infection with Streptococcus pneumoniae serotype 3 is linked to a higher risk of PNP.
- Vaccine strategies should consider the changing epidemiology of invasive pneumococcal disease and non-vaccine serotypes.
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