Acta Scientific Microbiology (ISSN: 2581-3226)

Case Report Volume 4 Issue 12

Cluster of Paediatric Severe Pneumonia Caused by Streptococcus pneumoniae Serotype 3 in Fully Vaccinated Children in Luxembourg

Julie Verbeke1,2, Bushra Zucca1,3, Valerie Flaum6, Paul Philipe6, Chantal Tsobo4, Alexandre Mzabi5, Monique Perrin5, Armand Biver1, Meriem Mastouri1 and Isabel de La Fuente Garcia1*

1Department of Pediatrics, National Center for Pediatrics, Centre Hospitalier de Luxembourg, Luxembourg
2Department of Pediatrics, University Hospital of Louvain-la-Neuve, Belgium
3Department of Pediatrics, University Hospital of Brussels, Belgium
4Microbiology Department, Centre Hospitalier de Luxembourg, Luxembourg
5Department of Microbiology, National Health Laboratory, Luxembourg
6Department of Paediatric Surgery, National Center for Pediatrics, Centre Hospitalier de Luxembourg, Luxembourg

*Corresponding Author: Isabel de La Fuente Garcia, Department of Pediatrics, National Center for Pediatrics, Centre Hospitalier de Luxembourg, Luxembourg.

Received: November 01, 2021 ; Published: November 24, 2021

Abstract

Streptococcus pneumoniae is the first cause of bacterial pneumonia in children. Since the implementation of routine immunization in 2004, the incidence of severe pneumococcal infections has decreased in Luxembourg. Thirteen-valent conjugated vaccine (PVC13), used routinely since 2010, is the only licensed pneumococcal conjugated vaccine with serotype 3 polysaccharide in its formulation. The incidence rate of empyema in Luxembourg was 5/100.000 person-years (children aged 0 to 6 years old) between 2014 and 2019, representing an annual average of 2.2 admissions in our National Paediatric center.

We report a cluster of 6 cases of complicated pneumonia (empyema, necrosis, and abscess) in otherwise healthy children hospitalized between December 2019 and February 2020 (9 weeks period). Their median age was 4 years (1-5). All of them had been vaccinated with PCV13 according to the national vaccination schedule in Luxembourg. All patients were treated with intravenous antibiotics. Four patients were transiently admitted to the intensive care unit. Two patients underwent video-assisted thoracoscopic surgery to debride the pleural space. All patients recovered from their pneumonia. Pneumococcal pneumonia was confirmed in five patients (positive PCR on pleural fluid) with serotyping being performed in four of them and identifying ser3 pneumococcus.

We present a cluster of cases of complicated pneumococcal pneumonia caused by ser3 pneumococcus in children vaccinated with PCV13. Several other European countries have reported cases of complicated ser3 pneumococcal pneumonia in previously vaccinated children, indicating the need for close monitoring of this serotype and development of better vaccination strategies against ser3 pneumococcus.

Keywords: Pneumococcal Pneumonia; Complicated Pneumonia; Streptococcus pneumoniae Serotype 3; Pneumococcal Conjugated Vaccine; Vaccine Failure

References

  1. Pivot D and Leite S. "Enquête de couverture vaccinale 2018 au Grand-Duché de Luxembourg". Le Gouvernement du Grand-Duché de Luxembourg (2018).
  2. Waight P., et al. “Effect of the 13-valent pneumococcal conjugate vaccine on invasive pneumococcal disease in England and Wales 4 years after its introduction: an observational cohort study”. Lancet Infectious Diseases 15 (2015): 535-543.
  3. Oligbu G., et al. “Pneumococcal conjugate vaccine failure in children: A systematic review of the literature”. Vaccine50 (2016): 6126-6132.
  4. Madhi F., et al. “Change in Bacterial Causes of Community-Acquired Parapneumonic Effusion and Pleural Empyema in Children 6 Years After 13-Valent Pneumococcal Conjugate Vaccine Implementation”. Journal of the Pediatric Infectious Diseases Society5 (2019): 474-477.
  5. Azzari C., et al. “Significant impact of pneumococcal conjugate vaccination on pediatric parapneumonic effusion: Italy 2006–2018”. Vaccine20 (2019): 2704-2711.
  6. Snape M., et al. “Immunogenicity and Reactogenicity of a 13-valent-pneumococcal conjugated vaccine administered at 2, 4, and 12 months of age”. The Pediatric Infectious Disease Journal 12 (2010): 80-90.
  7. Andrews N., et al. “Serotype-specific effectiveness and correlates of protection for the 13-valent pneumococcal conjugate vaccine: a postlicensure indirect cochort study”. Lancet Infectious Diseases9 (2014): 839-846.
  8. Choi EH., et al. “Capsular Polysaccharide (CPS) Release by Serotype 3 Pneumococcal Strains Reduces the Protective Effect of Anti-Type 3 CPS Antibodies”. Clinical and Vaccine Immunology2 (2016): 162-167.
  9. Bender J., et al. “Pneumococcal necrotizing pneumonia in Utah: does serotype matter?” Clinical Infectious Diseases 46 (2008): 1346-1352.
  10. Lodi L., et al. “Impact of the 13-Valent Pneumococcal Conjugate Vaccine on Severe Invasive Disease Caused by Serotype 3 Streptococcus pneumoniae in Italian Children”. Vaccine 7 (2019): 128.
  11. Silva-Costa C., et al. “Pediatric Complicated Pneumonia caused by Streptococcus pneumoniae serotype 3 in 13-valent pneumococcal conjugated vaccinees, Portugal, 2010-2015”. Emerging Infectious Disease7 (2018): 1307-1314.
  12. Moraga Llop F., et al. “Vaccine failures in patient properly vaccinated with 13-valent pneumococcal conjugate vaccine in Catalonia, a region with low vaccination coverage”. The Pediatric Infectious Disease Journal 35 (2016): 460-463.
  13. Antachopoulos C., et al. “Parapneumonic pleural effusions caused by Streptococcus pneumoniae serotype 3 in children immunized with 13-valent conjugated pneumococcal vaccine”. The Pediatric Infectious Disease Journal 33 (2014): 81-83.
  14. Oligbu G., et al. “Characteristics and serotype distribution of childhood cases of invasive pneumococcal disease following pneumonoccal conjugated vaccination in England et Wales, 2006-2014”. Clinical Infectious Disease7 (2017): 1191-1198.
  15. Goettler D., et al. “Increase in Streptococcus pneumoniae serotype 3 associated parapneumonic pleural effusion/empyema after the introduction of PCV13 in Germany”. Vaccine3 (2020): 570-577.
  16. Greenberg D., et al. “Safety and immunogenicity of 15-valent pneumococcal conjugate vaccine (PCV15) in healthy infants”. Vaccine45 (2018): 6883-6891.
  17. Brueggemann A., et al. “Changes in the incidence of invasive disease due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the Invasive Respiratory Infection Surveillance Initiative: a prospective analysis of surveillance data”. Lancet Digit Health 3 (2021): e360-370.

Citation

Citation: Isabel de La Fuente Garcia., et al. “Cluster of Paediatric Severe Pneumonia Caused by Streptococcus pneumoniae Serotype 3 in Fully Vaccinated Children in Luxembourg”. Acta Scientific Microbiology 4.12 (2021): 67-74.

Copyright

Copyright: © 2021 Isabel de La Fuente Garcia., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days
Impact Factor0.810

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is January 15, 2022.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US