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The aetiology of paediatric bloodstream infections changes after pneumococcal vaccination and group B streptococcus

Joachim Luthander1,2, Rutger Bennet1, Christian G Giske3

  • 1Paediatric Infectious Diseases Unit, Paediatric Emergency Department, Astrid Lindgren's Children Hospital, Stockholm, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|June 11, 2015
PubMed

Insights

Pneumococcal conjugate vaccination and intrapartum antibiotics significantly reduced bloodstream infections and early-onset sepsis in children. Staphylococcus aureus is now a key pathogen requiring targeted therapy.

Area of Science:

  • Pediatric Infectious Diseases
  • Vaccinology
  • Antimicrobial Resistance

Background:

  • Bloodstream infections (BSIs) and early-onset sepsis (EOS) pose significant risks to children.
  • Group B Streptococcus (GBS) and Streptococcus pneumoniae are common causes of pediatric BSIs and sepsis.
  • Antimicrobial resistance is a growing global health concern.

Purpose of the Study:

  • To evaluate the impact of pneumococcal conjugate vaccination (PCV) and risk-based intrapartum antibiotic prophylaxis (IAP) on BSIs and EOS.
  • To monitor trends in clinically relevant antimicrobial resistance in pediatric bloodstream infections.

Main Methods:

  • Retrospective analysis of 3986 positive blood cultures from children up to 17 years old.
  • Data collected from a pediatric hospital in Stockholm, Sweden, before and after the introduction of PCV and risk-based IAP in 2007-2008.
  • Monitoring of bacterial pathogens and their antimicrobial susceptibility patterns.

Main Results:

  • Significant decline in Streptococcus pneumoniae BSIs (42% overall, 62% in healthy children <36 months).
  • Marked reduction in early-onset sepsis due to group B Streptococcus (60%).
  • Staphylococcus aureus and Gram-negative bacteria emerged as dominant pathogens; overall antimicrobial resistance remained low.

Conclusions:

  • PCV and risk-based IAP are effective in reducing BSIs and EOS.
  • Current empirical antibiotic strategies should consider Staphylococcus aureus for invasive bacterial infections in children.
Abstract

Keywords:
AetiologyAntibiotic resistanceBloodstream infectionsGroup B streptococcusPneumococcus

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