Bacteremic pneumococcal community-acquired pneumonia in children less than 5 years of age in Italy

Susanna Esposito, Anna Marchese, Alberto E. Tozzi, Giovanni A. Rossi, Liviana Da Dalt, Gianni Bona, Claudio Pelucchi, Gian Carlo Schito, Nicola Principi

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: This study was designed to determine the proportion of bacteremic pneumococcal cases in a group of pediatric subjects with community-acquired pneumonia (CAP), the importance of the different serotypes and the impact of the currently available pneumococcal conjugate vaccines (PCVs). Methods: The study involved children who were ≤5 years with radiographically confirmed CAP admitted to hospital in Italy between September 2008 and March 2011. A diagnosis of laboratory-confirmed bacteremic pneumococcal CAP was made in the presence of a culture and/or real-time polymerase chain reaction (PCR) positive for Streptococcus pneumoniae. Results: A total of 510 children were included in the study. Pneumococcal CAP was diagnosed in 73 cases (14.3%): S. pneumoniae was identified by means of positive real-time PCR in 67 cases (91.8%), a positive blood culture in 1 (1.4%) and both in 5 (6.8%). Complicated pneumonia was observed significantly more often in the pneumococcal-positive cases (P = 0.02) and empyema was the main complication (P = 0.007). Serotype 19A was most frequently encountered (17 cases; 25.8%), followed by serotypes 14 (10 cases, 15.1%), 4 (5 cases, 7.6%) and 3 (4 cases, 6.1%). The theoretical coverage offered by the available PCVs was calculated to be 31% for PCV7, 37% for PCV10 and 71% for PCV13. Conclusions: In Italy, bacteremic pneumococcal CAP accounts for a significant number of CAP cases in children who were ≤5 years, with serotypes 19A and 14 being the most frequent. This suggests that PCV13 is the best means of preventing pneumococcal CAP.

Original languageEnglish
Pages (from-to)705-710
Number of pages6
JournalPediatric Infectious Disease Journal
Volume31
Issue number7
DOIs
Publication statusPublished - Jul 2012

Fingerprint

Italy
Pneumonia
Conjugate Vaccines
Pneumococcal Vaccines
Streptococcus pneumoniae
Real-Time Polymerase Chain Reaction
Empyema
Clinical Laboratory Techniques
Pediatrics
Serogroup

Keywords

  • Children
  • Community-acquired pneumonia
  • Pneumococcal conjugate vaccines
  • Pneumococcal serotypes
  • Streptococcus pneumoniae

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases
  • Microbiology (medical)

Cite this

Bacteremic pneumococcal community-acquired pneumonia in children less than 5 years of age in Italy. / Esposito, Susanna; Marchese, Anna; Tozzi, Alberto E.; Rossi, Giovanni A.; Dalt, Liviana Da; Bona, Gianni; Pelucchi, Claudio; Schito, Gian Carlo; Principi, Nicola.

In: Pediatric Infectious Disease Journal, Vol. 31, No. 7, 07.2012, p. 705-710.

Research output: Contribution to journalArticle

Esposito, S, Marchese, A, Tozzi, AE, Rossi, GA, Dalt, LD, Bona, G, Pelucchi, C, Schito, GC & Principi, N 2012, 'Bacteremic pneumococcal community-acquired pneumonia in children less than 5 years of age in Italy', Pediatric Infectious Disease Journal, vol. 31, no. 7, pp. 705-710. https://doi.org/10.1097/INF.0b013e31825384ae
Esposito, Susanna ; Marchese, Anna ; Tozzi, Alberto E. ; Rossi, Giovanni A. ; Dalt, Liviana Da ; Bona, Gianni ; Pelucchi, Claudio ; Schito, Gian Carlo ; Principi, Nicola. / Bacteremic pneumococcal community-acquired pneumonia in children less than 5 years of age in Italy. In: Pediatric Infectious Disease Journal. 2012 ; Vol. 31, No. 7. pp. 705-710.
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abstract = "Background: This study was designed to determine the proportion of bacteremic pneumococcal cases in a group of pediatric subjects with community-acquired pneumonia (CAP), the importance of the different serotypes and the impact of the currently available pneumococcal conjugate vaccines (PCVs). Methods: The study involved children who were ≤5 years with radiographically confirmed CAP admitted to hospital in Italy between September 2008 and March 2011. A diagnosis of laboratory-confirmed bacteremic pneumococcal CAP was made in the presence of a culture and/or real-time polymerase chain reaction (PCR) positive for Streptococcus pneumoniae. Results: A total of 510 children were included in the study. Pneumococcal CAP was diagnosed in 73 cases (14.3{\%}): S. pneumoniae was identified by means of positive real-time PCR in 67 cases (91.8{\%}), a positive blood culture in 1 (1.4{\%}) and both in 5 (6.8{\%}). Complicated pneumonia was observed significantly more often in the pneumococcal-positive cases (P = 0.02) and empyema was the main complication (P = 0.007). Serotype 19A was most frequently encountered (17 cases; 25.8{\%}), followed by serotypes 14 (10 cases, 15.1{\%}), 4 (5 cases, 7.6{\%}) and 3 (4 cases, 6.1{\%}). The theoretical coverage offered by the available PCVs was calculated to be 31{\%} for PCV7, 37{\%} for PCV10 and 71{\%} for PCV13. Conclusions: In Italy, bacteremic pneumococcal CAP accounts for a significant number of CAP cases in children who were ≤5 years, with serotypes 19A and 14 being the most frequent. This suggests that PCV13 is the best means of preventing pneumococcal CAP.",
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AU - Rossi, Giovanni A.

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AU - Pelucchi, Claudio

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