Outcome of Severe Bacterial Pneumonia in the Era of Pneumococcal Vaccination
Introduction: After the introduction of pneumococcal conjugate vaccines, community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae has decreased whereas Staphylococcus aureus and Streptococcus pyogenes could be increasing. These bacteria have been associated with high rates of complicati...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-12-01
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| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2020.576519/full |
| _version_ | 1818393998915534848 |
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| author | Teresa del Rosal María Belén Caminoa Alba González-Guerrero Iker Falces-Romero María Pilar Romero-Gómez Fernando Baquero-Artigao Talía Sainz Talía Sainz Ana Méndez-Echevarría Luis Escosa-García Francisco Javier Aracil Cristina Calvo Cristina Calvo |
| author_facet | Teresa del Rosal María Belén Caminoa Alba González-Guerrero Iker Falces-Romero María Pilar Romero-Gómez Fernando Baquero-Artigao Talía Sainz Talía Sainz Ana Méndez-Echevarría Luis Escosa-García Francisco Javier Aracil Cristina Calvo Cristina Calvo |
| author_sort | Teresa del Rosal |
| collection | DOAJ |
| description | Introduction: After the introduction of pneumococcal conjugate vaccines, community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae has decreased whereas Staphylococcus aureus and Streptococcus pyogenes could be increasing. These bacteria have been associated with high rates of complications.Aims: (1) To describe the characteristics of pediatric bacterial CAP requiring hospitalization. (2) To compare outcomes according to causative microorganisms. (3) To analyze changes in bacterial CAP rate and etiology over time.Patients and Methods: Retrospective single-center study of inpatients aged 1 month-16 years with culture-confirmed bacterial CAP in 2010-2018 in Madrid, Spain.Results: We included 64 cases (42 S. pneumoniae, 13 S. pyogenes and 9 S. aureus). Culture-confirmed CAP represented 1.48-2.33/1,000 all-cause pediatric hospital admissions, and its rate did not vary over time. However, there was a significant decrease in pneumococcal CAP in the last 3 years of the study (78% of CAP in 2010–2015 vs. 48% in 2016-18, p = 0.017). Median hospital stay was 10.5 days (interquartile range 5-19.5), 38 patients (59%) developed complications and 28 (44%) were admitted to the intensive care unit. Outcomes were similar among children with S. pneumoniae and S. aureus CAP, whereas S. pyogenes was associated with a higher risk for complications (OR 8 [95%CI 1.1-57.2]) and ICU admission (OR 7.1 [95%CI 1.7-29.1]) compared with pneumococcal CAP.Conclusion: In a setting with high PCV coverage, culture-confirmed bacterial CAP did not decrease over time and there was a relative increase of S. pyogenes and S. aureus. Children with CAP caused by S. pyogenes were more likely to develop complications. |
| first_indexed | 2024-12-14T05:54:13Z |
| format | Article |
| id | doaj.art-5169b0df18784bd28e36f8341e686333 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-14T05:54:13Z |
| publishDate | 2020-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-5169b0df18784bd28e36f8341e6863332022-12-21T23:14:37ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602020-12-01810.3389/fped.2020.576519576519Outcome of Severe Bacterial Pneumonia in the Era of Pneumococcal VaccinationTeresa del Rosal0María Belén Caminoa1Alba González-Guerrero2Iker Falces-Romero3María Pilar Romero-Gómez4Fernando Baquero-Artigao5Talía Sainz6Talía Sainz7Ana Méndez-Echevarría8Luis Escosa-García9Francisco Javier Aracil10Cristina Calvo11Cristina Calvo12Department of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, SpainDepartment of Pediatrics, Hospital de Torrejón, Madrid, SpainDepartment of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, SpainDepartment of Microbiology, Hospital Universitario La Paz, Madrid, SpainDepartment of Microbiology, Hospital Universitario La Paz, Madrid, SpainDepartment of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, SpainDepartment of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, SpainRed de Investigación Traslacional en Infectología Pediátrica, Madrid, SpainDepartment of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, SpainDepartment of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, SpainDepartment of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, SpainDepartment of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, SpainRed de Investigación Traslacional en Infectología Pediátrica, Madrid, SpainIntroduction: After the introduction of pneumococcal conjugate vaccines, community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae has decreased whereas Staphylococcus aureus and Streptococcus pyogenes could be increasing. These bacteria have been associated with high rates of complications.Aims: (1) To describe the characteristics of pediatric bacterial CAP requiring hospitalization. (2) To compare outcomes according to causative microorganisms. (3) To analyze changes in bacterial CAP rate and etiology over time.Patients and Methods: Retrospective single-center study of inpatients aged 1 month-16 years with culture-confirmed bacterial CAP in 2010-2018 in Madrid, Spain.Results: We included 64 cases (42 S. pneumoniae, 13 S. pyogenes and 9 S. aureus). Culture-confirmed CAP represented 1.48-2.33/1,000 all-cause pediatric hospital admissions, and its rate did not vary over time. However, there was a significant decrease in pneumococcal CAP in the last 3 years of the study (78% of CAP in 2010–2015 vs. 48% in 2016-18, p = 0.017). Median hospital stay was 10.5 days (interquartile range 5-19.5), 38 patients (59%) developed complications and 28 (44%) were admitted to the intensive care unit. Outcomes were similar among children with S. pneumoniae and S. aureus CAP, whereas S. pyogenes was associated with a higher risk for complications (OR 8 [95%CI 1.1-57.2]) and ICU admission (OR 7.1 [95%CI 1.7-29.1]) compared with pneumococcal CAP.Conclusion: In a setting with high PCV coverage, culture-confirmed bacterial CAP did not decrease over time and there was a relative increase of S. pyogenes and S. aureus. Children with CAP caused by S. pyogenes were more likely to develop complications.https://www.frontiersin.org/articles/10.3389/fped.2020.576519/fullpneumoniapneumococcal infectionspleural effusionempyema pleuralStreptococcus pneumoniaeStreptococcus pyogenes |
| spellingShingle | Teresa del Rosal María Belén Caminoa Alba González-Guerrero Iker Falces-Romero María Pilar Romero-Gómez Fernando Baquero-Artigao Talía Sainz Talía Sainz Ana Méndez-Echevarría Luis Escosa-García Francisco Javier Aracil Cristina Calvo Cristina Calvo Outcome of Severe Bacterial Pneumonia in the Era of Pneumococcal Vaccination Frontiers in Pediatrics pneumonia pneumococcal infections pleural effusion empyema pleural Streptococcus pneumoniae Streptococcus pyogenes |
| title | Outcome of Severe Bacterial Pneumonia in the Era of Pneumococcal Vaccination |
| title_full | Outcome of Severe Bacterial Pneumonia in the Era of Pneumococcal Vaccination |
| title_fullStr | Outcome of Severe Bacterial Pneumonia in the Era of Pneumococcal Vaccination |
| title_full_unstemmed | Outcome of Severe Bacterial Pneumonia in the Era of Pneumococcal Vaccination |
| title_short | Outcome of Severe Bacterial Pneumonia in the Era of Pneumococcal Vaccination |
| title_sort | outcome of severe bacterial pneumonia in the era of pneumococcal vaccination |
| topic | pneumonia pneumococcal infections pleural effusion empyema pleural Streptococcus pneumoniae Streptococcus pyogenes |
| url | https://www.frontiersin.org/articles/10.3389/fped.2020.576519/full |
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