Related Experiment Video
Updated: Apr 28, 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
Pneumococcal Pneumonia in Hospitalized Children: 2017-2023
Eric E Engstrom1, Sheldon L Kaplan1, William J Barson2
1Texas Children's Hospital and Baylor College of Medicine, Houston, Texas.
Insights
COVID-19 pandemic altered pediatric pneumococcal pneumonia trends. Serotype 3 increased post-2020, linked to severe outcomes, while resistance was mainly from serotype 19A.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Microbiology
Background:
- Streptococcus pneumoniae is a leading cause of childhood pneumonia.
- The COVID-19 pandemic may have influenced the epidemiology of pneumococcal pneumonia.
Purpose of the Study:
- To investigate changes in pediatric Streptococcus pneumoniae pneumonia before, during, and after the COVID-19 pandemic.
- To analyze variations in clinical presentation, serotypes, and antibiotic susceptibility.
Main Methods:
- Retrospective analysis of 190 pediatric patients with culture-positive pneumonia from 2017-2023 across 8 US children's hospitals.
- Serotyping of pneumococcal isolates and collection of clinical and laboratory data.
Main Results:
- Pneumococcal pneumonia cases decreased in 2020, surging in 2022-2023. Serotype 3 became most common post-2021, associated with higher rates of empyema and necrotizing pneumonia.
- PCV13 serotypes remained dominant, but PCV15 and PCV20 serotypes comprised 14% and 22% of isolates, respectively. Penicillin susceptibility was high (94%), with resistance linked to serotype 19A.
- Influenza coinfection was associated with increased pneumonia complications.
Conclusions:
- Streptococcus pneumoniae continues to cause severe pediatric pneumonia.
- Post-2020 increases are linked to serotype 3, and β-lactam resistance to serotype 19A.
- Pneumococcal conjugate vaccines PCV15 and PCV20 may further decrease incidence.
Objectives:
We hypothesized that the incidence, clinical presentation, isolate serotypes, and isolate antibiotic susceptibility of Streptococcus pneumoniae causing pneumonia in children varied before and through the course of the COVID-19 pandemic.
Methods:
Patients aged 18 years or younger at 8 children's hospitals in the United States admitted with culture-positive pneumonia were identified. Serotyping of pneumococcal isolates was performed at a central research laboratory. Clinical and laboratory data were collected retrospectively with a standardized case report form.
Results:
We identified 190 patients with pneumococcal pneumonia from 2017 to 2023. Cases decreased significantly in 2020 (P < .05), with a surge in 2022 and 2023. Serotype 3 was the most common serotype, was prominent after 2021, and was associated with a significantly higher rate of empyema and necrotizing parenchyma (P < .001). PCV13 serotypes 3, 19A, and 19F constituted over half of isolates; new serotypes in PCV15 (22F and 33F) and PCV20 (8, 10A, 11A, 12F, 15B, 22F, and 33F) accounted for 14% and 22% of isolates, respectively. Penicillin susceptibility (minimum inhibitory concentration [MIC] ≤ 2 μg/mL) was very common (94% of isolates), and all 11 isolates with MIC greater than 2 μg/mL were serotype 19A. Of those tested, 90 patients had viral coinfections; only influenza was associated with more pneumonia complications compared with patients without influenza (P = .002).
Conclusions:
S pneumoniae remains an important cause of pneumonia in children with the potential for severe infections. After 2020, increasing rates have primarily been due to serotype 3, while β-lactam resistance was largely associated with serotype 19A. PCV15 and PCV20 may modestly reduce pneumococcal pneumonia incidence further.
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
06:06Constructing Mutants in Serotype 1 Streptococcus pneumoniae strain 519/43
Published on: September 11, 2020
Related Concept Videos
01:29Pneumonia I: Introduction
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
01:28Pneumonia 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:
01:29Pneumonia II: Pathophysiology