Catarina Silva-Costa1, Joana Gomes-Silva1,Marcos Pinho, Mario Ramirez1 , José Melo-Cristino1 ∙ on behalf of the Portuguese Group for the Study of Streptococcal Infections and the Portuguese Study Group of Invasive Pneumococcal Disease of the Pediatric Infectious Disease Society
Portuguese Study Group of Invasive Pneumococcal Disease of the Pediatric Infectious Disease Society: Catarina Gouveia2, Sónia Aires6, Cristina Ferreira11, Eurico Gaspar15, Manuela Ferreira1, Fernanda Pereira44, Maria José Dinis14, Álvaro Sousa13, Paulo Teixeira39, José Amorim33, Cláudia Monteiro35, Isabel Carvalho10, Sofia Arosa30, Margarida Guedes13, Laura Marques13, Ana Braga13, Margarida Tavares21, Isabel Cunha22, Lurdes Vicente45, Maria Manuel Zarcos20, Helena Almeida41, Silvia Almeida28, Fernanda Rodrigues5, Cristina Resende5, Eulália Afonso16, Luísa Mendes7, Cristina Faria29, Ana Luísa Teixeira46, António Mendes47, Teresa Tomé2, Mónica Rebelo2, Filomena Pereira48, Gustavo Rodrigues49, Alexandra Costa10, Ana Teixeira10, Sofia Lima36, Érica Laima42, Maria Ana S. Nunes50, Filipa Prata8, Pedro Flores34, Manuela Brandão25, João Calado Nunes38, Rosário Massa51, Florbela Cunha32, Paula Correia26, Anabela Brito4, João Franco27, Cristina Didelet52, Estela Veiga37, Carla Cruz24, Graça Seves12, Céu Novais23, Maria João Virtuoso3, Nancy Guerreiro3, Amélia Cavaco17, Francisco Gomes53, Dora Gomes54 & Isabel Monteiro55.
1 - Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
2 - Unidade de Infeciologia, Departamento de Pediatria, HDE, ULSSJose
- J Infect. 2024 Oct;89(4):106242. doi: 10.1016/j.jinf.2024.106242. Epub 2024 Aug 6. PMID: 39116949
Resumo:
Objectives The COVID-19 pandemic led to the institution of public health measures in many countries which reduced respiratory infections. We aimed to identify and characterize changes in pediatric (<18 years) invasive pneumococcal disease (pIPD) in Portugal in 2018–2023.
Methods pIPD cases were identified by culture and molecular methods and stratified by age and serotype. When available the susceptibility of the isolates to antimicrobials was evaluated.
Results pIPD cases were markedly reduced in the last trimester of 2019–2020 and the entire 2020–2021 season. While 2021–2022 was in line with pre-pandemic seasons, in 2022–2023, the number of pIPD cases exceeded those found pre-pandemic. Molecular tests were responsible for identifying and serotyping 30% of cases, highlighting their importance in evaluating pIPD. Among the 316 pIPD cases, 37 different serotypes were detected, of which serotypes 3 (n = 85, 26.9%), 8 (n = 25, 7.9%), 10A (n = 21, 6.6%) and 24F (n = 20, 6.3%) were the most frequent. The post-pandemic serotype distribution reflected mostly pre-pandemic trends and the rebound was not driven by particular serotypes. We identified many vaccine failures, most (n = 37) representing serotype 3 infections. Penicillin non-susceptibility increased from 14% pre-pandemic to 29%, with serotype 24F becoming particularly significant.
Conclusions The higher number of cases of pIPD post-COVID-19 in Portugal raises the possibility of a higher burden of pneumococcal disease in Europe post-pandemic. The relatively stable serotype distribution and the current availability of the higher valency conjugate vaccines PCV15 and PCV20, potentially preventing a large proportion of pIPD (43% and 67%, respectively), offer an opportunity to control this increase.