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

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Streptococcus pneumoniae (Pnc) serotypes differ in invasive potential. We examined whether community-acquired alveolar pneumonia (CAAP) in children carrying commonly recognized pneumonia invasive pneumococcal serotypes ([PnIST] 1, 5, 7F, 14, and 19A) differs from CAAP in children carrying less invasive serotypes (non-PnIST) or no Pnc (Pnc-neg). Methods: 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 and demographic characteristics were recorded. The study was conducted before pneumococcal conjugate vaccine implementation in Israel. Results: A total of 1423 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 PnIST carriage compared with both groups: temperature ≥39°C, peripheral white blood cell count ≥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 nonsignificant. Conclusions: 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-PnIST or not carrying Pnc.

Original languageEnglish
Pages (from-to)812-819
Number of pages8
JournalJournal of Infectious Diseases
Volume221
Issue number5
DOIs
StatePublished - 18 Feb 2020

Keywords

  • children
  • clinical signs
  • community-acquired alveolar pneumonia
  • laboratory characteristics
  • pneumococcal serotypes

Fingerprint

Dive into the research topics of 'Nasopharyngeal Carriage of Invasive Pneumococcal Serotypes during Childhood Community-Acquired Alveolar Pneumonia Is Associated with Specific Clinical Presentation'. Together they form a unique fingerprint.

Cite this