Linny Kimly Phuong, Abigail Cheung, Tiarni Templeton, Tamrat Abebe, Zanfina Ademi, Jim Buttery, Julia Clark, Theresa Cole, Nigel Curtis, Hazel Dobinson, Nadha Shahul Hameed, Hayley Hernstadt, Samar Ojaimi, Ella Grace Sharp, Praisoody Sinnaparajar, Sophie Wen, Andrew Daley, Brendan McMullan, Amanda Gwee
{"title":"澳大利亚儿童侵袭性肺炎球菌疾病流行病学：前瞻性队列研究。","authors":"Linny Kimly Phuong, Abigail Cheung, Tiarni Templeton, Tamrat Abebe, Zanfina Ademi, Jim Buttery, Julia Clark, Theresa Cole, Nigel Curtis, Hazel Dobinson, Nadha Shahul Hameed, Hayley Hernstadt, Samar Ojaimi, Ella Grace Sharp, Praisoody Sinnaparajar, Sophie Wen, Andrew Daley, Brendan McMullan, Amanda Gwee","doi":"10.1136/archdischild-2024-327497","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The widespread use of pneumococcal conjugate vaccines (PCV) has changed the epidemiology of invasive pneumococcal disease (IPD) in children globally.</p><p><strong>Methods: </strong>Multicentre prospective audit of IPD episodes from five paediatric hospitals in Australia over 5.5 years between 2016 and June 2021. Children (<18 years) with <i>Streptococcus pneumoniae</i> isolated from a sterile site were included.</p><p><strong>Results: </strong>There were 377 IPD episodes in 375 children: 338 (90%) had received ≥3 PCV doses; 42 (11%) had IPD risk factors. The most common presentations were complicated pneumonia (254, 67%), bacteraemia (65, 17%) and meningitis (29, 8%). Five (1%) children died.Serotype information was available for 230 (61%) episodes; 140 (61%) were 13vPCV vaccine serotypes (VTs). The majority (85%) of episodes of complicated pneumonia were due to a VT; predominantly 3, 19A, 19F. Children with risk factors were more likely to present with bacteraemia ± sepsis (42% vs 12%) and to have a non-vaccine serotype (NVT) (74% vs 32%). Resistance to ceftriaxone (meningitis cut-off) occurred in 17% of 23B isolates (n=12) and accounted for 22% (5/23) of meningitis cases.</p><p><strong>Conclusions: </strong>Complicated pneumonia is the most common IPD presentation. NVTs account for the majority of bacteraemia and meningitis episodes. High rates of ceftriaxone resistance for NVT 23B support the addition of vancomycin for empiric treatment of suspected meningitis.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"52-58"},"PeriodicalIF":4.3000,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Epidemiology of childhood invasive pneumococcal disease in Australia: a prospective cohort study.\",\"authors\":\"Linny Kimly Phuong, Abigail Cheung, Tiarni Templeton, Tamrat Abebe, Zanfina Ademi, Jim Buttery, Julia Clark, Theresa Cole, Nigel Curtis, Hazel Dobinson, Nadha Shahul Hameed, Hayley Hernstadt, Samar Ojaimi, Ella Grace Sharp, Praisoody Sinnaparajar, Sophie Wen, Andrew Daley, Brendan McMullan, Amanda Gwee\",\"doi\":\"10.1136/archdischild-2024-327497\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The widespread use of pneumococcal conjugate vaccines (PCV) has changed the epidemiology of invasive pneumococcal disease (IPD) in children globally.</p><p><strong>Methods: </strong>Multicentre prospective audit of IPD episodes from five paediatric hospitals in Australia over 5.5 years between 2016 and June 2021. Children (<18 years) with <i>Streptococcus pneumoniae</i> isolated from a sterile site were included.</p><p><strong>Results: </strong>There were 377 IPD episodes in 375 children: 338 (90%) had received ≥3 PCV doses; 42 (11%) had IPD risk factors. The most common presentations were complicated pneumonia (254, 67%), bacteraemia (65, 17%) and meningitis (29, 8%). Five (1%) children died.Serotype information was available for 230 (61%) episodes; 140 (61%) were 13vPCV vaccine serotypes (VTs). The majority (85%) of episodes of complicated pneumonia were due to a VT; predominantly 3, 19A, 19F. Children with risk factors were more likely to present with bacteraemia ± sepsis (42% vs 12%) and to have a non-vaccine serotype (NVT) (74% vs 32%). Resistance to ceftriaxone (meningitis cut-off) occurred in 17% of 23B isolates (n=12) and accounted for 22% (5/23) of meningitis cases.</p><p><strong>Conclusions: </strong>Complicated pneumonia is the most common IPD presentation. NVTs account for the majority of bacteraemia and meningitis episodes. High rates of ceftriaxone resistance for NVT 23B support the addition of vancomycin for empiric treatment of suspected meningitis.</p>\",\"PeriodicalId\":8150,\"journal\":{\"name\":\"Archives of Disease in Childhood\",\"volume\":\" \",\"pages\":\"52-58\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-12-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Disease in Childhood\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/archdischild-2024-327497\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Disease in Childhood","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/archdischild-2024-327497","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Epidemiology of childhood invasive pneumococcal disease in Australia: a prospective cohort study.
Background: The widespread use of pneumococcal conjugate vaccines (PCV) has changed the epidemiology of invasive pneumococcal disease (IPD) in children globally.
Methods: Multicentre prospective audit of IPD episodes from five paediatric hospitals in Australia over 5.5 years between 2016 and June 2021. Children (<18 years) with Streptococcus pneumoniae isolated from a sterile site were included.
Results: There were 377 IPD episodes in 375 children: 338 (90%) had received ≥3 PCV doses; 42 (11%) had IPD risk factors. The most common presentations were complicated pneumonia (254, 67%), bacteraemia (65, 17%) and meningitis (29, 8%). Five (1%) children died.Serotype information was available for 230 (61%) episodes; 140 (61%) were 13vPCV vaccine serotypes (VTs). The majority (85%) of episodes of complicated pneumonia were due to a VT; predominantly 3, 19A, 19F. Children with risk factors were more likely to present with bacteraemia ± sepsis (42% vs 12%) and to have a non-vaccine serotype (NVT) (74% vs 32%). Resistance to ceftriaxone (meningitis cut-off) occurred in 17% of 23B isolates (n=12) and accounted for 22% (5/23) of meningitis cases.
Conclusions: Complicated pneumonia is the most common IPD presentation. NVTs account for the majority of bacteraemia and meningitis episodes. High rates of ceftriaxone resistance for NVT 23B support the addition of vancomycin for empiric treatment of suspected meningitis.
期刊介绍：
Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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