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Pneumococcal aetiology and serotype distribution in paediatric community-acquired pneumonia.

De Schutter I, Vergison A, Tuerlinckx D, Raes M, Smet J, Smeesters PR, Verhaegen J, Mascart F, Surmont F, Malfroot A - PLoS ONE (2014)

Bottom Line: The pneumococcal detection rate adjusted for the whole study population was 61.7%.Serotypes 1 (42.3%), 5 (16.0%), and 7F(7A) (12.8%) were predominant.In conclusion, Streptococcus pneumoniae remains the predominant bacteria in children hospitalised for CAP in Belgium after implementation of 7-valent pneumococcal conjugate vaccine, with non-vaccine-serotypes accounting for the majority of cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Pulmonology, Cystic Fibrosis Clinic and Pediatric Infectious Diseases, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.

ABSTRACT
Community-acquired pneumonia (CAP) is a major cause of morbidity in children. This study estimated the proportion of children with pneumococcal CAP among children hospitalised with CAP in Belgium and describes the causative serotype distribution after implementation of the 7-valent pneumococcal conjugate vaccine. Children 0-14 years hospitalised with X-ray-confirmed CAP were prospectively enrolled in a multicentre observational study. Acute and convalescent blood samples were collected. Pneumococcal aetiology was assessed by conventional methods (blood or pleural fluid cultures with Quellung reaction capsular typing or polymerase chain reaction [PCR] in pleural fluid), and recently developed methods (real-time PCR in blood and World Health Organization-validated serotype-specific serology). A total of 561 children were enrolled. Pneumococcal aetiology was assessed by conventional methods in 539, serology in 171, and real-time PCR in blood in 154. Pneumococcal aetiology was identified in 12.2% (66/539) of the children by conventional methods alone but in 73.9% by the combination of conventional and recently developed methods. The pneumococcal detection rate adjusted for the whole study population was 61.7%. Serotypes 1 (42.3%), 5 (16.0%), and 7F(7A) (12.8%) were predominant. In conclusion, Streptococcus pneumoniae remains the predominant bacteria in children hospitalised for CAP in Belgium after implementation of 7-valent pneumococcal conjugate vaccine, with non-vaccine-serotypes accounting for the majority of cases. The use of recently developed methods improves diagnosis of pneumococcal aetiology.

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Flowchart of patients evaluated by the different detection methods.Conventional methods: blood culture, culture of pleural fluid, or polymerase chain reaction in pleural fluid. Recently developed methods: serotype-specific serology (SSS) or real-time polymerase chain reaction in blood (rtPCR). SSS included serotypes 1, 5, 6B(6D), 7F(7A), 9V(9N), 14, 19A, 19F, and 23F. rtPCR included serotypes 1, 3, 4, 5, 6A(6C), 6B(6D), 7F(7A), 9V(9N), 14, 18C(18B), 19A, 19F, and 23F.
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pone-0089013-g001: Flowchart of patients evaluated by the different detection methods.Conventional methods: blood culture, culture of pleural fluid, or polymerase chain reaction in pleural fluid. Recently developed methods: serotype-specific serology (SSS) or real-time polymerase chain reaction in blood (rtPCR). SSS included serotypes 1, 5, 6B(6D), 7F(7A), 9V(9N), 14, 19A, 19F, and 23F. rtPCR included serotypes 1, 3, 4, 5, 6A(6C), 6B(6D), 7F(7A), 9V(9N), 14, 18C(18B), 19A, 19F, and 23F.

Mentions: The study included 561 children hospitalised in Belgium with radiologically confirmed CAP (Figure 1). The majority were boys (57.8%; p = 0.0002) and the median age was 3.6 years (IQR, 2.3–5.4 years; range, 3 months – 14 years 10 months). Forty-seven (8.4%) patients had at least one comorbidity, most of which were recurrent lower respiratory tract infections (3.7%) and asthma (1.6%). The majority (57.9%) of patients had received pneumococcal vaccination. Of these, 88% were fully vaccinated according to their age. All but five patients had received PCV7. The latter had received the 23-valent polysaccharide vaccine (Pneumo23, Sanofi Pasteur MSD).


Pneumococcal aetiology and serotype distribution in paediatric community-acquired pneumonia.

De Schutter I, Vergison A, Tuerlinckx D, Raes M, Smet J, Smeesters PR, Verhaegen J, Mascart F, Surmont F, Malfroot A - PLoS ONE (2014)

Flowchart of patients evaluated by the different detection methods.Conventional methods: blood culture, culture of pleural fluid, or polymerase chain reaction in pleural fluid. Recently developed methods: serotype-specific serology (SSS) or real-time polymerase chain reaction in blood (rtPCR). SSS included serotypes 1, 5, 6B(6D), 7F(7A), 9V(9N), 14, 19A, 19F, and 23F. rtPCR included serotypes 1, 3, 4, 5, 6A(6C), 6B(6D), 7F(7A), 9V(9N), 14, 18C(18B), 19A, 19F, and 23F.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928328&req=5

pone-0089013-g001: Flowchart of patients evaluated by the different detection methods.Conventional methods: blood culture, culture of pleural fluid, or polymerase chain reaction in pleural fluid. Recently developed methods: serotype-specific serology (SSS) or real-time polymerase chain reaction in blood (rtPCR). SSS included serotypes 1, 5, 6B(6D), 7F(7A), 9V(9N), 14, 19A, 19F, and 23F. rtPCR included serotypes 1, 3, 4, 5, 6A(6C), 6B(6D), 7F(7A), 9V(9N), 14, 18C(18B), 19A, 19F, and 23F.
Mentions: The study included 561 children hospitalised in Belgium with radiologically confirmed CAP (Figure 1). The majority were boys (57.8%; p = 0.0002) and the median age was 3.6 years (IQR, 2.3–5.4 years; range, 3 months – 14 years 10 months). Forty-seven (8.4%) patients had at least one comorbidity, most of which were recurrent lower respiratory tract infections (3.7%) and asthma (1.6%). The majority (57.9%) of patients had received pneumococcal vaccination. Of these, 88% were fully vaccinated according to their age. All but five patients had received PCV7. The latter had received the 23-valent polysaccharide vaccine (Pneumo23, Sanofi Pasteur MSD).

Bottom Line: The pneumococcal detection rate adjusted for the whole study population was 61.7%.Serotypes 1 (42.3%), 5 (16.0%), and 7F(7A) (12.8%) were predominant.In conclusion, Streptococcus pneumoniae remains the predominant bacteria in children hospitalised for CAP in Belgium after implementation of 7-valent pneumococcal conjugate vaccine, with non-vaccine-serotypes accounting for the majority of cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Pulmonology, Cystic Fibrosis Clinic and Pediatric Infectious Diseases, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.

ABSTRACT
Community-acquired pneumonia (CAP) is a major cause of morbidity in children. This study estimated the proportion of children with pneumococcal CAP among children hospitalised with CAP in Belgium and describes the causative serotype distribution after implementation of the 7-valent pneumococcal conjugate vaccine. Children 0-14 years hospitalised with X-ray-confirmed CAP were prospectively enrolled in a multicentre observational study. Acute and convalescent blood samples were collected. Pneumococcal aetiology was assessed by conventional methods (blood or pleural fluid cultures with Quellung reaction capsular typing or polymerase chain reaction [PCR] in pleural fluid), and recently developed methods (real-time PCR in blood and World Health Organization-validated serotype-specific serology). A total of 561 children were enrolled. Pneumococcal aetiology was assessed by conventional methods in 539, serology in 171, and real-time PCR in blood in 154. Pneumococcal aetiology was identified in 12.2% (66/539) of the children by conventional methods alone but in 73.9% by the combination of conventional and recently developed methods. The pneumococcal detection rate adjusted for the whole study population was 61.7%. Serotypes 1 (42.3%), 5 (16.0%), and 7F(7A) (12.8%) were predominant. In conclusion, Streptococcus pneumoniae remains the predominant bacteria in children hospitalised for CAP in Belgium after implementation of 7-valent pneumococcal conjugate vaccine, with non-vaccine-serotypes accounting for the majority of cases. The use of recently developed methods improves diagnosis of pneumococcal aetiology.

Show MeSH
Related in: MedlinePlus