Related Experiment Video
Updated: Jan 2, 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
Changing Epidemiology and Predisposing Factors for Invasive Pneumococcal Disease at Two Australian Tertiary Hospitals
Hayley Hernstadt1,2, Abigail Cheung3, Daniel Hurem4
1From the Department of Paediatric Infectious Diseases, St Mary's Hospital, Imperial College Healthcare Trust, London, United Kingdom.
Insights
Invasive pneumococcal disease (IPD) in vaccinated children can signal underlying immunodeficiency. Non-vaccine serotypes are emerging, and antibiotic resistance warrants careful treatment considerations.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Vaccinology
Background:
- Invasive pneumococcal disease (IPD) significantly impacts child health.
- Universal pneumococcal conjugate vaccination has altered IPD epidemiology.
- IPD in vaccinated children may indicate underlying immunodeficiency.
Purpose of the Study:
- To audit pediatric IPD cases in Australia (2011-2017).
- To analyze predisposing conditions, serotypes, and antibiotic susceptibility.
- To assess the role of immunologic evaluation in IPD cases.
Main Methods:
- Retrospective audit of children under 18 with IPD.
- Data collection on clinical presentation, risk factors, serotypes, and treatment.
- Analysis of antibiotic susceptibility and immunologic evaluations.
Main Results:
- 131 IPD presentations in 127 children over 7 years.
- Common presentations: sepsis, empyema, meningitis.
- Emerging non-vaccine serotypes and 11% ceftriaxone non-susceptibility observed.
Conclusions:
- Vaccine-type serotypes remain common, but non-vaccine serotypes are increasing.
- Vancomycin is recommended for pneumococcal meningitis due to resistance.
- Investigating underlying conditions is crucial in vaccinated children with IPD.
Background:
Invasive pneumococcal disease (IPD) is associated with significant morbidity and mortality in children. Universal pneumococcal conjugate vaccination has changed the epidemiology of IPD. In vaccinated children, IPD can be a marker of an underlying immunodeficiency.
Methods:
This is a retrospective audit of children younger than 18 years with IPD admitted to 2 tertiary pediatric hospitals in Australia between 2011 and 2017. Data on predisposing conditions, immunologic evaluation, pneumococcal serotype, antibiotic susceptibility and treatment were collected.
Results:
During the 7-year period, there were 131 presentations with IPD in 127 children; 3 children had recurrent IPD. Patients presented with sepsis (41%), empyema (29%), meningitis (18%), mastoiditis (12%), pneumonia (10%) and septic arthritis (4%). In 19 (15%) presentations, risk factors for IPD were present, including malignancy, hematologic disorder, chronic liver disease, chronic kidney disease and cochlear implant. Pneumococcal serotypes were determined in 78/131 (60%) of presentations: the most frequent serotypes were 19A (19%), 3 (13%), 7F (10%) and 19F (8%) and non-vaccine serotypes 22F (8%), 35B (6%), 15A (4%) and 38 (4%). Overall, 11% of isolates were non-susceptible to ceftriaxone. Only 36 patients (32%) had an immunologic evaluation, and 4 patients had proven or probable immunodeficiency.
Conclusion:
Although pneumococcal conjugate vaccine serotypes 19A, 3, 19F and 7F remain frequent causes of IPD, non-vaccine serotypes are emerging. Our data support vancomycin treatment for children with pneumococcal meningitis given 11% of our isolates were not susceptible to ceftriaxone. It is important to consider underlying conditions predisposing to IPD in a population with high rates of pneumococcal vaccination.
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
01:30Pneumonia 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...
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:30Pneumonia III: Complications and Assessment
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...
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...