Related Experiment Video
Updated: Apr 30, 2026
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Invasive pneumococcal disease in children can reveal a primary immunodeficiency
Jean Gaschignard1, Corinne Levy2, Maya Chrabieh3
1Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale UMR1163 University Paris Descartes, Sorbonne Paris Cité, Imagine Institute, Paris, France Groupe de Pathologie Infectieuse Pédiatrique, France.
Insights
Primary immunodeficiencies (PIDs) are linked to invasive pneumococcal disease (IPD) in children. Immunological investigations are recommended, especially for those over two years old, to identify PIDs in up to 26% of cases.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Immunology
- Genetics
Background:
- Invasive pneumococcal disease (IPD) has a significant mortality rate in children.
- Primary immunodeficiencies (PIDs) are suspected risk factors for IPD, but a systematic evaluation in pediatric IPD cases is lacking.
Purpose of the Study:
- To systematically investigate the prevalence of PIDs in hospitalized pediatric patients diagnosed with IPD.
- To identify specific PIDs associated with increased susceptibility to IPD in children.
Main Methods:
- Prospective study of pediatric IPD cases hospitalized between 2005-2011 across 28 French pediatric wards.
- Immunological assessment included blood counts, immunoglobulin and complement levels, and cytokine evaluation.
- IPD diagnosis confirmed by positive culture, PCR, or antigen detection from sterile sites.
Main Results:
- 163 children with IPD were included; 10% were diagnosed with a PID.
- PIDs were more prevalent in children over 2 years old (26%) compared to younger children (3%).
- Identified PIDs included MyD88 deficiency, complement deficiencies (C2/C3), congenital asplenia, and Bruton disease.
Conclusions:
- Immunological investigations are crucial for children diagnosed with IPD.
- The likelihood of identifying a PID increases significantly in children over 2 years of age presenting with IPD.
Background:
About 10% of pediatric patients with invasive pneumococcal disease (IPD) die from the disease. Some primary immunodeficiencies (PIDs) are known to confer predisposition to IPD. However, a systematic search for these PIDs has never been carried out in children presenting with IPD.
Methods:
We prospectively identified pediatric cases of IPD requiring hospitalization between 2005 and 2011 in 28 pediatric wards throughout France. IPD was defined as a positive pneumococcal culture, polymerase chain reaction result, and/or soluble antigen detection at a normally sterile site. The immunological assessment included abdominal ultrasound, whole-blood counts and smears, determinations of plasma immunoglobulin and complement levels, and the evaluation of proinflammatory cytokines.
Results:
We included 163 children with IPD (male-to-female ratio, 1.3; median age, 13 months). Seventeen children had recurrent IPD. Meningitis was the most frequent type of infection (87%); other infections included pleuropneumonitis, isolated bloodstream infection, osteomyelitis, endocarditis, and mastoiditis. One patient with recurrent meningitis had a congenital cerebrospinal fluid fistula. The results of immunological explorations were abnormal in 26 children (16%), and a PID was identified in 17 patients (10%), including 1 case of MyD88 deficiency, 3 of complement fraction C2 or C3 deficiencies, 1 of isolated congenital asplenia, and 2 of Bruton disease (X-linked agammaglobulinemia). The proportion of PIDs was much higher in children aged >2 years than in younger children (26% vs 3%; P < .001).
Conclusions:
Children with IPD should undergo immunological investigations, particularly those aged >2 years, as PIDs may be discovered in up to 26% of cases.
More Related Videos
12:21A Mouse Model for the Transition of Streptococcus pneumoniae from Colonizer to Pathogen upon Viral Co-Infection Recapitulates Age-Exacerbated Illness
Published on: September 28, 2022
09:12Characterization of Inflammatory Responses During Intranasal Colonization with Streptococcus pneumoniae
Published on: January 17, 2014
Related Concept Videos
01:25Immunodeficiency Diseases
There are three main causes of immunodeficiency...
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:29Pneumonia I: Introduction
01:22Development of Immunocompetence
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...