[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]
Nasopharyngeal carriage of invasive pneumococcal serotypes during childhood community-acquired alveolar pneumonia is associated with specific clinical presentation
Yaniv Faingelernt, Ron Dagan, Noga Givon-Lavi, Shalom Ben-Shimol, Jacob Bar-Ziv, David Greenberg
The Journal of Infectious Diseases, jiz513, https://doi.org/10.1093/infdis/jiz513
Published: 05 October 2019
Streptococcus pneumoniae (Pnc) serotypes differ in invasive potential. We examined whether community-acquired alveolar pneumonia (CAAP) in children carrying common recognized invasive pneumococcal serotypes (1, 5, 7F, 14 and 19A; PnIST) differs from CAAP in children carrying less invasive serotypes (non-PnIST) or no Pnc (Pnc-neg).
Children <5 years visiting the only regional Pediatric Emergency Room, with radiologically-proven CAAP were enrolled. Nasopharyngeal cultures were processed for pneumococcal isolation and serotyping. Clinical/demographic characteristics were recorded. The study was conducted before pneumococcal conjugate vaccine implementation in Israel.
A total of 1,423 CAAP episodes were recorded: PnIST, 300 (21.1%); non-PnIST, 591 (41.5%); and Pnc-neg, 532 (37.4%). After adjustment for age, ethnicity, seasonality and previous antibiotics, the following variables were positively associated with PnISRT carriage compared to both groups: temperature ≥39°C, peripheral WBC ≥20,000/mm3, C-reactive protein ≥70.0 mg/L and serum sodium <135 mEq/L. Lower oxygen saturation, viral detection and comorbidities were negatively associated with Pn-IST carriage (odds ratios <1.0). Differences between non-PnIST carriers and Pnc-neg groups were smaller or non-significant.
Young children with CAAP carrying common PnIST had a lower proportion of comorbidities, hypoxemia and viral detection, and had more intense systemic inflammatory response than those carrying non-PnISR or not carrying Pnc.
community-acquired alveolar pneumonia, children, pneumococcal serotypes, clinical signs, laboratory characteristics
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Keywords: Streptococcus pneumoniae; Invasive pneumococcal disease; Pediatrics.