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Publication
Sustained importance of Streptococcus pneumoniae among pediatric complicated Pneumonia in Portugal (2019-22)
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Advisor(s)
Abstract(s)
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.
Description
Portuguese Group for the Study of Streptococcal Infections: Margarida Pinto, Miguel Seruca, João Marques, Isabel Peres, Teresa Pina, Isabel Lourenço, Teresa Ferreira, Cristina Marcelo, Isabel Daniel, Odete Chantre, Teresa Vaz, Marília Gião, Rui Ferreira, Rui Tomé Ribeiro, Celeste Pontes, Luísa Boaventura, Catarina Chaves, Teresa Reis, Henrique Oliveira, Catarina Chaves, Mariana Silva, Ana Aguiar, Hugo Loureiro, Adriana Pedrosa, Hermínia Costa, Maria Fátima Silva, Maria Amélia Afonso, Mariana Fardilha, Natália Novais, Isabel Brito, Luís Marques Lito, Ana Bruschy Fonseca, Filomena Martins, Maria Ana Pessanha, Elsa Gonçalves, Teresa Morais, Cristina Toscano, Paulo Lopes, Angelina Lameirão, Gabriela Abreu, Aurélia Selaru, Ana Paula Mota Vieira, Margarida Tomaz, Cláudia Ferreira, Marta Nicolau, Maria Helena Ramos, Ana Paula Castro, Virgínia Lopes, Fernando Fonseca, Ana Paula Castro, Nuno Canhoto, Teresa Afonso, Ilse Fontes, Paulo Martinho, Gina Marrão, Ana Domingos, José Grossinho, Manuela Ribeiro, Helena Gonçalves, Alberta Faustino, Maria Cármen Iglesias, Maria Paula Pinheiro, Rui Semedo, Adriana Coutinho, Luísa Gonçalves, Olga Neto, Luísa Sancho, José Diogo, Filipa Fortunato, Isabel Nascimento, Nadiya Kruptsala, Cláudia Fidalgo, Elmano Ramalheira, Raquel Diaz, Sónia Ferreia, Inês Cravo Roxo, Isabel Vale, Maria João Tomás, Maria Antónia Read, Valquíria Alves, Margarida Monteiro, Margarida Rodrigues, José Mota Freitas, Sandra Vieira, Elsa Calado, Paula Pinto, Ana Custódio, Maria Favila Menezes, José Germano de Sousa, Mariana Bettencourt Viana, Marvin Oliveira, Isaura Terra, Vitória Rodrigues, Sofia Marques, Joana Selada, Patrícia Pereira, Jesuína Duarte, Paula Pinto, Ezequiel Moreira, Adília Vicente, Fátima Vale, Joana Ramos, Rita Gralha, Ana Helena Correia, Paula Gama, Catarina Silva-Costa, Joana Gomes-Silva, Marcos Pinho, Célia Rodrigues Bettencourt, Miguel Pinto;
Portuguese Study Group of Paediatric Invasive Streptococcal Disease: Sónia Aires, Eurico Gaspar, Manuela Ferreira, Fernanda Pereira, Graça Pombo, Maria José Dinis, Paulo Teixeira, José Amorim, Cláudia Monteiro, Diana Moreira, Sofia Arosa, Laura Marques, Margarida Tavares, Maria Manuel Zarcos, Sílvia Almeida, Fernanda Rodrigues, Jorge Rodrigues, Pedro Carvalho, Catarina Gouveia, Ana Isabel Carvalho, Alexandra Costa, Elsa Gonçalves, Filipa Prata, João Calado Nunes, Julieta Morais, Florbela Cunha, Paula Correia, Ana Margarida Chaves, Sofia Lima, João Neves, João Bivar, Pedro Flores, Sofia Fraga, Isabel Brito, Cristina Didelet, Estela Veiga, Carla Cruz, Graça Seves, Céu Novais, Maria João Virtuoso, Nancy Guerreiro, Francisco Gomes, Dora Gomes, Carolina Gonçalves, Nuno Canhoto
Abstract publicado em ESPID 2023 Abstracts Book, p. 79: https://espidmeeting.org/wp-content/uploads/sites/19/2023/05/ESPID23-Abstracts-Book.pdf
Abstract publicado em ESPID 2023 Abstracts Book, p. 79: https://espidmeeting.org/wp-content/uploads/sites/19/2023/05/ESPID23-Abstracts-Book.pdf
Keywords
Streptococcus Pyogenes Streptococcus pneumoniae Pneumoniae Paediatric Infections Infecções Respiratórias Portugal