Related Experiment Video
Updated: Jan 10, 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
Post-pandemic increase in pediatric invasive pneumococcal disease driven by serotype 3
Jorge Benito Arribas1, Celina García Pérez1, Emilia Cercenado2
1Faculty of Medicine, Complutense University of Madrid, Madrid, Spain.
Insights
Pediatric invasive pneumococcal disease (IPD) declined during COVID-19 but resurged, driven by serotype 3. This serotype caused severe illness and fatalities despite high vaccination rates, highlighting the need for updated vaccines.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Vaccinology
Background:
- Invasive pneumococcal disease (IPD) remains a significant pediatric health concern.
- The COVID-19 pandemic altered respiratory pathogen circulation and pediatric infectious disease patterns.
Purpose of the Study:
- To analyze trends in pediatric IPD before and after the COVID-19 pandemic.
- To identify pathogens, severity, and outcomes associated with pediatric IPD.
Main Methods:
- Retrospective study of children under 18 with confirmed IPD.
- Data collected from January 2018 to April 2023 in Madrid, Spain.
- Analysis of clinical, microbiological, and vaccination data, comparing pre- and post-pandemic periods.
Main Results:
- A decline in IPD cases was observed during the early COVID-19 pandemic, with a subsequent rise in incidence and severity post-pandemic.
- Serotype 3 was the most common cause of IPD, strongly associated with severe disease, PICU admissions, and one fatality.
- Severe cases and PICU admissions were significantly more frequent in the post-pandemic period, even in fully vaccinated children.
Conclusions:
- A resurgence of pediatric IPD, particularly due to serotype 3, was observed after the COVID-19 pandemic.
- Serotype 3 IPD is linked to increased severity and poor outcomes, irrespective of vaccination status.
- Improved vaccine formulations and adaptive immunization strategies are crucial for managing pediatric IPD.
Background:
Invasive pneumococcal disease (IPD) remains a significant cause of morbidity in children despite widespread use of conjugate vaccines. The COVID-19 pandemic led to unprecedented changes in respiratory pathogen circulation and pediatric infectious disease epidemiology.
Materials And Methods:
We conducted a retrospective study of children under 18 years admitted with confirmed IPD to a tertiary hospital in Madrid, Spain (January 2018-April 2023). Clinical, microbiological, and vaccination data were analyzed, with comparisons by disease severity and pre-/post-pandemic period (March 15, 2020).
Results:
A total of 38 children were included (median age 27 months). Most (76.3 %) had no recognized risk factors for IPD. Pneumonia was the most frequent presentation (47.4 %), and 57.9 % met severity criteria. A marked decline in IPD occurred during the early COVID-19 pandemic (March 2020-August 2021), with no confirmed cases during that period. However, incidence and severity rose from late 2022. Severe cases were significantly more frequent post-pandemic (42.1 % vs. 73.7 %, p = 0.049). Fourteen patients (36.8 %) required PICU admission; one death (2.6 %) occurred in a previously healthy, fully vaccinated child with serotype 3 meningitis. Serotype 3 was most common (23.7 %) and strongly linked to severity (40.9 % of severe cases), occurring in fully vaccinated children in 88.9 % of cases.
Conclusions:
Following COVID-19, a resurgence in pediatric IPD was observed, largely driven by serotype 3. This serotype was linked to greater severity, PICU admissions, and one fatal outcome, despite high PCV13 coverage. These findings underscore the need for improved vaccine formulations, sustained surveillance, and timely adaptation of immunization strategies.
Related Concept Videos
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 II: Pathophysiology
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....
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...