Rebound of pediatric invasive pneumococcal disease in Portugal after the COVID-19 pandemic was not associated with significant serotype changes - 17/09/24
, José Melo-Cristinoon behalf of the Portuguese Group for the Study of Streptococcal Infections and the Portuguese Study Group of Invasive Pneumococcal Disease of the Pediatric Infectious Disease Society2
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Summary |
Objectives |
The COVID-19 pandemic led to the institution of public health measures in many countries which reduced respiratory infections. We aimed to identify and characterize changes in pediatric (<18 years) invasive pneumococcal disease (pIPD) in Portugal in 2018–2023.
Methods |
pIPD cases were identified by culture and molecular methods and stratified by age and serotype. When available the susceptibility of the isolates to antimicrobials was evaluated.
Results |
pIPD cases were markedly reduced in the last trimester of 2019–2020 and the entire 2020–2021 season. While 2021–2022 was in line with pre-pandemic seasons, in 2022–2023, the number of pIPD cases exceeded those found pre-pandemic. Molecular tests were responsible for identifying and serotyping 30% of cases, highlighting their importance in evaluating pIPD. Among the 316 pIPD cases, 37 different serotypes were detected, of which serotypes 3 (n = 85, 26.9%), 8 (n = 25, 7.9%), 10A (n = 21, 6.6%) and 24F (n = 20, 6.3%) were the most frequent. The post-pandemic serotype distribution reflected mostly pre-pandemic trends and the rebound was not driven by particular serotypes. We identified many vaccine failures, most (n = 37) representing serotype 3 infections. Penicillin non-susceptibility increased from 14% pre-pandemic to 29%, with serotype 24F becoming particularly significant.
Conclusions |
The higher number of cases of pIPD post-COVID-19 in Portugal raises the possibility of a higher burden of pneumococcal disease in Europe post-pandemic. The relatively stable serotype distribution and the current availability of the higher valency conjugate vaccines PCV15 and PCV20, potentially preventing a large proportion of pIPD (43% and 67%, respectively), offer an opportunity to control this increase.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Pediatric pneumococcal invasive disease decreased during the COVID-19 pandemic. |
• | Rebound exceeded pre-pandemic levels with serotypes reflecting pre-pandemic trends. |
• | Molecular methods are essential to detect an important fraction of invasive disease. |
• | Vaccine failures or breakthrough cases occurred mostly with serotype 3. |
• | Non-vaccine types are important contributors to antimicrobial resistance. |
Keywords : Streptococcus pneumoniae, Invasive disease, Vaccines, Molecular diagnostics, Serotypes, Epidemiology, Pediatric infectious disease
Plan
Vol 89 - N° 4
Article 106242- octobre 2024 Retour au numéro
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