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Browsing by Author "Portuguese Study Group of Pediatric Invasive Streptococcal Disease"

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  • Sustained importance of Streptococcus pneumoniae among pediatric complicated Pneumonia in Portugal (2019-22)
    Publication . Gomes-Silva, J.; Silva-Costa, Catarina; Pinho, Marcos; Friães, Ana; Ramirez, Mário; Melo-Cristino, José; Portuguese Group for the Study of Streptococcal Infections; Portuguese Study Group of Pediatric Invasive Streptococcal Disease
    Backgrounds: To improve the etiological diagnosis of culture-negative pediatric complicated pneumonia (PCP), we expanded our real-time PCR assay to include other bacterial agents and evaluate potential changes in etiology after 7 years of near universal use of 13-valent conjugate pneumococcal vaccine (PCV13). Methods: We collected 156 culture-negative pleural fluid and empyema samples from children (<18 years), in 62 hospitals in Portugal, from January 2019 to December 2022. Our assay included Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Mycoplasma pneumoniae, Haemophilus influenzae, Mycobacterium tuberculosis and Streptococcus agalactiae. For S. pneumoniae cases we performed molecular serotyping. Results: Overall, 78 samples were negative for all bacteria tested (50.0%). Among the remaining 78 samples, the majority was positive for S. pneumoniae (n=64, 41.0%). S. pyogenes was found in 7 samples (4.49%), S. aureus in 5 samples (3.20%), H. influenzae in 2 samples (1.28%), and M. pneumoniae in 1 sample (0.64%). We did not detect M. tuberculosis nor S. agalactiae. In 2 samples, we detected the presence of DNA from both S. pneumoniae and another species: S. aureus (n=1) and H. influenzae (n=1). Among the pneumococcal samples, 44 were serotype 3 (56.4%), 5 were serotype 8 (6.41%), 2 were serotype 14 (2.56%) and serotypes 15A, 16F, 19A, 19F and 6C/6D were detected in 1 sample each (1.28% each). The remaining were negative for all serotypes tested (4.49%). Conclusions/Learning Points: After two decades of pneumococcal conjugate vaccine use, S. pneumoniae is still responsible for most culture-negative PCPs, with PCV13 serotype 3 responsible for most cases. Expanding the molecular diagnostic panel to other species allowed the identification of the etiology of only an additional 9.62% of cases, suggesting that bacteria other than S. pneumoniae remain infrequent despite PCV13 use.
    2023-05-09Conference object Open access Show more
  • Sustained increase of paediatric invasive Streptococcus pyogenes infections dominated by M1UK and diverse emm12 isolates, Portugal, September 2022 to May 2023
    Publication . Gouveia, Catarina; Bajanca-Lavado, Maria Paula; Mamede, Rafael; Araújo Carvalho, Ana; Rodrigues, Fernanda; Melo-Cristino, José; Ramirez, Mario; Friães, Ana; Portuguese Group for the Study of Streptococcal Infections; Portuguese Study Group of Pediatric Invasive Streptococcal Disease
    Since autumn 2022, observed numbers of paediatric invasive group A Streptococcus infections in Portugal (n = 89) were higher than in pre-COVID-19 seasons. Between September 2022 and May 2023, the dominant diagnoses were pneumonia (25/79), mostly with empyema (20/25), and sepsis (22/79). A number of cases required admission to intensive care (27/79) and surgery (35/79), and the case fatality rate was 5.1% (4/79). Genomic sequencing (n = 55) revealed multiple genetic lineages, dominated by the M1UK sublineage (26/55) and more diverse emm12 isolates (12/55).
    2023-09Journal article Open access Show more