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Necrotizing pneumonia among Italian children in the pneumococcal conjugate vaccine era.
Carloni, Ines; Ricci, Silvia; Rubino, Chiara; Cobellis, Giovanni; Rinaldelli, Giampaolo; Azzari, Chiara; de Benedictis, Fernando M.
Afiliación
  • Carloni I; Pediatric Infectious Disease Unit, Department of Mother and Child Health, Salesi Children's Hospital, Ancona, Italy.
  • Ricci S; Department of Health Sciences, Meyer Children's University Hospital, Florence, Italy.
  • Rubino C; Department of Health Sciences, Meyer Children's University Hospital, Florence, Italy.
  • Cobellis G; Pediatric Surgery Unit, Department of Mother and Child Health, Salesi Children's Hospital, Ancona, Italy.
  • Rinaldelli G; Pediatric Intensive Care Unit, Department of Mother and Child Health, Salesi Children's Hospital, Ancona, Italy.
  • Azzari C; Department of Health Sciences, Meyer Children's University Hospital, Florence, Italy.
  • de Benedictis FM; Salesi Children's Hospital Foundation, Ancona, Italy.
Pediatr Pulmonol ; 56(5): 1127-1135, 2021 05.
Article en En | MEDLINE | ID: mdl-33442941
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.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neumonía Neumocócica / Neumonía Necrotizante Límite: Child, preschool / Humans País/Región como asunto: Europa Idioma: En Revista: Pediatr Pulmonol Asunto de la revista: PEDIATRIA Año: 2021 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neumonía Neumocócica / Neumonía Necrotizante Límite: Child, preschool / Humans País/Región como asunto: Europa Idioma: En Revista: Pediatr Pulmonol Asunto de la revista: PEDIATRIA Año: 2021 Tipo del documento: Article País de afiliación: Italia