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Published on: February 23, 2014
Streptococcus pneumoniae Remains Leading Cause of Bacteremia in Children Despite 13-Valent Pneumococcal Conjugate
María Garrido Rodríguez1, Ana María Borrull Senra2, Susanna Hernández-Bou2
1Pediatric Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
Insights
Streptococcus pneumoniae causes most bloodstream infections in young children, even after the 13-valent pneumococcal conjugate vaccine (PCV13). Many infections are localized, but severe cases and poor outcomes persist, often due to non-vaccine serotypes.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Vaccinology
Background:
- The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced to reduce invasive pneumococcal disease.
- Understanding current epidemiology is crucial for public health strategies.
Purpose of the Study:
- To describe the epidemiology and primary diagnoses of young children with positive blood cultures post-PCV13 introduction.
- To compare current findings with pre-PCV13 data.
Main Methods:
- A multicenter, cross-sectional, retrospective registry study.
- Data collected from seven pediatric emergency departments (PEDs) between 2017 and 2022.
- Findings compared to a similar registry from 2011-2016.
Main Results:
- Streptococcus pneumoniae was the most common bacterium (36.6%).
- Focal infection was the most frequent diagnosis (54.3%), but severe invasive bacterial infections occurred in 19.1%.
- Poor outcomes were seen in 29.8% of patients, with non-PCV13 serotypes predominating.
Conclusions:
- Streptococcus pneumoniae remains a leading cause of bacteremia in young children, with non-vaccine serotypes being prevalent.
- Despite localized infections, severe invasive bacterial infections and poor outcomes remain significant concerns.
- Continued surveillance and potential vaccine updates are warranted.
Aim:
To describe the epidemiology and primary diagnoses of previously healthy children aged 3-59 months who presented to paediatric emergency departments (PEDs) with a positive blood culture following the introduction of the publicly funded 13-valent pneumococcal conjugate vaccine (PCV13).
Methods:
We conducted a multicentre, cross-sectional, retrospective registry study in seven PEDs between 2017 and 2022. The findings were compared with those of a similar registry from 2011 to 2016.
Results:
During the funded PCV13 period, 278 patients were recorded. The most frequently isolated bacteria were Streptococcus pneumoniae (36.6%), Escherichia coli (12.6%), and Streptococcus pyogenes (9.4%) [Correction added on 7 August 2025, after first online publication: The percentage for Streptococcus pyogenes was corrected from (29.4%) to (9.4%).]. The most common diagnosis was focal infection (54.3%), followed by bacteremia without a focus of infection (26.6%), and severe invasive bacterial infection (19.1%). Poor outcomes were observed in 29.8% of patients. The most common serotypes during the funded PCV13 period were 10A, 24, and 8, none of which are included in PCV13.
Conclusions:
Streptococcus pneumoniae remained the leading cause of bacteremia in previously healthy children aged 3-59 months, with a predominance of non-vaccine serotypes. Although half of the patients had a localised infection, a substantial proportion developed severe invasive bacterial infections. Poor outcomes occurred in one out of every three to four invasive bacterial infections.
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