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Pneumococcal serotypes in children, clinical presentation and antimicrobial susceptibility in the PCV13 era

C Izquierdo1, P Ciruela1,2, S Hernández1

  • 1Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain.

Epidemiology and Infection
|November 5, 2020
PubMed

Insights

Invasive pneumococcal disease in children is often caused by 13-valent pneumococcal conjugate vaccine (PCV13) serotypes, particularly 3, 1, and 19A. Non-PCV13 serotypes are linked to severe conditions like meningitis, highlighting the need for ongoing antibiotic resistance monitoring.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Invasive pneumococcal disease (IPD) remains a significant global health concern in children.
  • Understanding serotype distribution and antimicrobial susceptibility is crucial for effective prevention and treatment strategies.

Purpose of the Study:

  • To analyze invasive pneumococcal disease (IPD) serotypes in children up to 17 years old.
  • To correlate serotypes with clinical presentations and antimicrobial resistance patterns.

Main Methods:

  • Prospective study conducted from January 2012 to June 2016.
  • IPD diagnosis using culture and/or real-time polymerase chain reaction (PCR).
  • Analysis of demographic, microbiological, and clinical data, including odds ratios (OR) and 95% confidence intervals (CI).

Main Results:

  • Over 64% of 253 IPD cases involved 13-valent pneumococcal conjugate vaccine (PCV13) serotypes.
  • Serotypes 3 and 1 were associated with complicated pneumonia; non-PCV13 serotypes linked to meningitis and occult bacteremia.
  • Significant rates of non-susceptibility to penicillin (36.1%) and cefotaxime (16.4%) were observed, with specific serotypes linked to resistance.

Conclusions:

  • PCV13 serotypes, particularly 3, 1, and 19A, are predominant in pediatric IPD.
  • Distinct serotype associations exist for different clinical presentations (e.g., PCV13 for pneumonia, non-PCV13 for meningitis).
  • Continuous monitoring of antibiotic resistance in non-PCV13 serotypes is essential.

Keywords:
Antimicrobial susceptibilityPCV13 vaccineStreptococcus pneumoniaeinvasive pneumococcal diseasepenicillin resistanceserotype distribution

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