What the study found
Pneumococcal pneumonia in hospitalized children decreased in 2020, then surged in 2022 and 2023. After 2021, serotype 3 became prominent, and penicillin susceptibility was common overall, with higher-level resistance mainly tied to serotype 19A.
Why the authors say this matters
The authors conclude that Streptococcus pneumoniae remains an important cause of pneumonia in children and can still be associated with severe infection. They suggest PCV15 and PCV20, newer pneumococcal conjugate vaccines, may modestly reduce pneumococcal pneumonia incidence further.
What the researchers tested
The researchers reviewed children 18 years or younger who were admitted with culture-positive pneumonia at 8 children's hospitals in the United States from 2017 to 2023. They performed serotyping of pneumococcal isolates at a central research laboratory and collected clinical and laboratory data retrospectively using a standardized case report form.
What worked and what didn't
They identified 190 patients with pneumococcal pneumonia. Serotype 3 was the most common serotype, was associated with more empyema and necrotizing parenchyma, and was especially prominent after 2021; all 11 isolates with penicillin MIC greater than 2 micrograms per milliliter were serotype 19A. Of the viral coinfections tested, only influenza was associated with more pneumonia complications than no influenza.
What to keep in mind
The study is limited to hospitalized children at 8 U.S. children's hospitals and to culture-positive pneumonia cases. The abstract does not describe additional limitations beyond this scope.
Key points
- Cases of pneumococcal pneumonia fell in 2020 and rose in 2022 and 2023.
- Serotype 3 was the most common serotype and was linked to more empyema and necrotizing parenchyma.
- All 11 penicillin-nonsusceptible isolates were serotype 19A.
- PCV15 and PCV20 serotypes made up 14% and 22% of isolates, respectively.
- Among viral coinfections, only influenza was associated with more pneumonia complications.
Disclosure
- Research title:
- Pneumococcal pneumonia rose after 2020 in hospitalized children
- Authors:
- Eric E. Engstrom, Sheldon L. Kaplan, William J. Barson, Philana Ling Lin, Steven Dahl, John S. Bradley, Pia S. Pannaraj, Tina Q. Tan, Jennifer Dien Bard, Kacy Ramirez, Lindsay R. Grant, Adriano Arguedas, Maria J. Tort, Ashley Miller, Alejandro Cané, Kristina G. Hultén
- Institutions:
- Texas Children's Hospital, Nationwide Children's Hospital, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Arkansas Children's Hospital, Rady Children's Hospital-San Diego, Northwestern University, Lurie Children's Hospital, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, University of Southern California, Children's Hospital of Los Angeles, Wake Forest University, The Fertilizer Institute
- Publication date:
- 2026-04-27
- OpenAlex record:
- View
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