What the study found
Pneumococcal pneumonia in hospitalized children changed over time during the COVID-19 period, with fewer cases in 2020 and more cases in 2022 and 2023. The study also found shifts in the types of Streptococcus pneumoniae (the bacteria that cause pneumococcal disease) and in antibiotic susceptibility.
Why the authors say this matters
The authors conclude that Streptococcus pneumoniae remains an important cause of pneumonia in children and can be associated with severe infection. They suggest that PCV15 and PCV20, which are pneumococcal conjugate vaccines covering additional serotypes (bacterial subtypes), may modestly reduce pneumococcal pneumonia incidence further.
What the researchers tested
The researchers retrospectively identified patients aged 18 years or younger admitted with culture-positive pneumonia at 8 children's hospitals in the U.S. from 2017 to 2023. They performed serotyping at a central research laboratory and collected clinical and laboratory data using a standardized case report form.
What worked and what didn't
A total of 190 patients with pneumococcal pneumonia were identified. Cases decreased significantly in 2020 and then surged in 2022 and 2023; serotype 3 was most common, especially after 2021, and was associated with higher rates of empyema and necrotizing parenchyma. Penicillin susceptibility was common overall, but all 11 isolates with higher minimum inhibitory concentration values were serotype 19A; among viral coinfections, only influenza was associated with more pneumonia complications than no influenza.
What to keep in mind
The abstract does not describe detailed study limitations. The data come from hospitalized children at 8 U.S. children's hospitals, so the findings are limited to that setting and to the cases identified in this retrospective study.
- Pneumococcal pneumonia cases in hospitalized children dropped in 2020 and then increased in 2022 and 2023.
- Serotype 3 was the most common type and was linked to more empyema and necrotizing parenchyma.
- Most isolates were penicillin-susceptible, while all isolates with higher resistance were serotype 19A.
- Influenza was the only viral coinfection associated with more pneumonia complications than no influenza.
- The authors say PCV15 and PCV20 may modestly reduce pneumococcal pneumonia incidence further.
