Background: Necrotizing pneumonia (NP) is a severe complication of community-acquired pneumonia. The impact of 13-valent pneumococcal conjugate vaccine (PCV13) on the epidemiology of NP in children has not been assessed. Patients and methods: Medical records of children less than 18 years admitted with NP to two pediatric hospitals in Italy between 2005 and 2019 were reviewed. The following four periods were defined: 2005–2010 (pre-PCV13), 2011–2013 (early post-PCV13), 2014–2016 (intermediate post-PCV13), and 2017–2019 (late post-PCV13). Results: Forty-three children (median age, 44 months) were included. Most of them (93%) were previously healthy. No differences in age, sex, season of admission, comorbidity, clinical presentation, or hospital course were identified between pre-PCV13 and post-PCV13 periods. A significant decrease in the rate of NP-associated hospitalizations was found between the early (1.5/1000 admissions/year) and the intermediate (0.35/1000 admissions/year) post-PCV13 period (p =.001). An increased trend in admissions was found thereafter. Streptococcus pneumoniae was the most common agent detected in both periods (pre-PCV13: 11/18, 61%; post-PCV13: 13/25, 52%). Serotype 3 was the most common strain in both periods (pre-PCV13: 3/11, 27%; post-PCV13; 4/13, 31%). There were no changes in the etiology over time, but most patients with Streptococcus pyogenes or Staphylococcus aureus infection were admitted during the post-PCV13 period. Conclusions: The hospitalization rate for NP in children decreased a few years after the implementation of PCV13 immunization in Italy. However, an increased trend in admissions was found thereafter. S. pneumoniae was the most frequent causal agent in both pre- and post-PCV13 periods. Pneumococcal serotypes were mainly represented by Strain 3. © 2021 Wiley Periodicals LLC

Necrotizing pneumonia among italian children in the pneumococcal conjugate vaccine era / Carloni, I; Ricci, S; Rubino, C; Cobellis, G; Azzari, C; de Benedictis, Fm. - In: PEDIATRIC PULMONOLOGY. - ISSN 8755-6863. - STAMPA. - 56(5):5(2021), pp. 1127-1135. [10.1002/ppul.25270]

Necrotizing pneumonia among italian children in the pneumococcal conjugate vaccine era

Cobellis G
Membro del Collaboration Group
;
2021-01-01

Abstract

Background: Necrotizing pneumonia (NP) is a severe complication of community-acquired pneumonia. The impact of 13-valent pneumococcal conjugate vaccine (PCV13) on the epidemiology of NP in children has not been assessed. Patients and methods: Medical records of children less than 18 years admitted with NP to two pediatric hospitals in Italy between 2005 and 2019 were reviewed. The following four periods were defined: 2005–2010 (pre-PCV13), 2011–2013 (early post-PCV13), 2014–2016 (intermediate post-PCV13), and 2017–2019 (late post-PCV13). Results: Forty-three children (median age, 44 months) were included. Most of them (93%) were previously healthy. No differences in age, sex, season of admission, comorbidity, clinical presentation, or hospital course were identified between pre-PCV13 and post-PCV13 periods. A significant decrease in the rate of NP-associated hospitalizations was found between the early (1.5/1000 admissions/year) and the intermediate (0.35/1000 admissions/year) post-PCV13 period (p =.001). An increased trend in admissions was found thereafter. Streptococcus pneumoniae was the most common agent detected in both periods (pre-PCV13: 11/18, 61%; post-PCV13: 13/25, 52%). Serotype 3 was the most common strain in both periods (pre-PCV13: 3/11, 27%; post-PCV13; 4/13, 31%). There were no changes in the etiology over time, but most patients with Streptococcus pyogenes or Staphylococcus aureus infection were admitted during the post-PCV13 period. Conclusions: The hospitalization rate for NP in children decreased a few years after the implementation of PCV13 immunization in Italy. However, an increased trend in admissions was found thereafter. S. pneumoniae was the most frequent causal agent in both pre- and post-PCV13 periods. Pneumococcal serotypes were mainly represented by Strain 3. © 2021 Wiley Periodicals LLC
2021
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Descrizione: This is the pre-peer reviewed version of the following article: Carloni I, Ricci S, Rubino C, et al. Necrotizing pneumonia among Italian children in the pneumococcal conjugate vaccine era. Pediatric Pulmonology. 2021; 56: 1127-1135, which has been published in final form at https://doi.org/10.1002/ppul.25270. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
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Descrizione: This is the pre-peer reviewed version of the following article: Carloni I, Ricci S, Rubino C, et al. Necrotizing pneumonia among Italian children in the pneumococcal conjugate vaccine era. Pediatric Pulmonology. 2021; 56: 1127-1135, which has been published in final form at https://doi.org/10.1002/ppul.25270. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11566/288186
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