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NECROTIZING PNEUMONIA AMONG ITALIAN CHILDREN IN THE PNEUMOCOCCAL CONJUGATE VACCINE ERA
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  • Ines Carloni,
  • Silvia Ricci,
  • Chiara Rubino,
  • Giovanni Cobellis,
  • Giampaolo Rinaldelli,
  • Chiara Azzari,
  • Fernando de Benedictis
Ines Carloni
Azienda Ospedaliero-Universitaria Ospedali Riuniti

Corresponding Author:[email protected]

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Silvia Ricci
Meyer Children’s University Hospital
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Chiara Rubino
Meyer Children’s University Hospital,
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Giovanni Cobellis
Salesi Children's Hospital
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Giampaolo Rinaldelli
Salesi Children’s Hospital,
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Chiara Azzari
University of Florence and Meyer Children’s Hospital,
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Fernando de Benedictis
Salesi Children's Hospital Foundation
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Abstract

ABSTRACT Background: Necrotizing pneumonia (NP) is a severe complication of community-acquired pneumonia. The impact of 13-valent pneumococcal conjugate vaccine (PCV13) on the epidemiology of NP in children has not been formally assessed. Patients and methods: Medical records of children <18 years admitted with NP to two pediatric hospitals in Italy between 2005 through 2019 were retrospectively reviewed. The following 4 periods were defined: 2005-2010 (pre-PCV13), 2011-2013 (early post-PCV13), 2014-2016 (intermediate post-PCV13), and 2017-2019 (late post-PCV13). Results: Forty-three children (median age, 44 months) were included. Most of them (93%) were previously healthy. No differences in age, sex, season of admission, comorbidity, clinical presentation, or hospital course were identified between pre-PCV13 and post-PCV13 periods. A significant decrease in the rate of NP-associated hospitalizations was found between the early (1.5/1000 admissions/year) and the intermediate (0.35/1000 admissions/year) post-PCV13 period (p=0.001). Streptococcus pneumoniae was the most common agent detected in both periods (pre-PCV13: 11/18, 61%; post-PCV13: 13/25, 52%). Serotype 3 was the most common strain in both periods (pre-PCV13: 3/11, 27%; post-PCV13; 4/13, 31%). There were no changes in the bacterial etiology over time, but most patients with Streptococcus pyogenes or Staphylococcus aureus infection were admitted during the post-PCV13 period. Conclusions: The hospitalization rate for NP in children decreased a few years after the implementation of PCV13 immunization in Italy. However, an increased trend in admissions was found thereafter. S. pneumoniae was the most frequent causal agent in both pre- and post-PCV13 periods. Pneumococcal serotypes were mainly represented by strain 3.
25 Aug 2020Submitted to Pediatric Pulmonology
25 Aug 2020Submission Checks Completed
25 Aug 2020Assigned to Editor
26 Aug 2020Review(s) Completed, Editorial Evaluation Pending
06 Sep 2020Reviewer(s) Assigned
26 Sep 2020Editorial Decision: Revise Minor
29 Nov 20201st Revision Received
30 Nov 2020Submission Checks Completed
30 Nov 2020Assigned to Editor
30 Nov 2020Reviewer(s) Assigned
21 Dec 2020Review(s) Completed, Editorial Evaluation Pending
22 Dec 2020Editorial Decision: Revise Minor
23 Dec 20202nd Revision Received
24 Dec 2020Assigned to Editor
24 Dec 2020Submission Checks Completed
24 Dec 2020Reviewer(s) Assigned
24 Dec 2020Review(s) Completed, Editorial Evaluation Pending
26 Dec 2020Editorial Decision: Accept
May 2021Published in Pediatric Pulmonology volume 56 issue 5 on pages 1127-1135. 10.1002/ppul.25270