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Aetiology of paediatric pneumonia after the introduction of pneumococcal conjugate vaccine

Lookup NU author(s): Dr Mohamed Elemraid, Dr John Perry, Professor Stephen Rushton, Dr David Spencer, Dr Matthew Thomas, Dr Katherine Eastham, Dr Fiona Hampton, Professor Andrew GenneryORCiD



We describe the aetiology of community-acquired pneumonia in children before and after the introduction of the pneumococcal conjugate vaccination (PCV) programme in 2006.Prospective studies were conducted in 2001-2002 (pre-vaccine) and 2009-2011 (post-vaccine) of children aged 0-16 years with radiologically confirmed pneumonia seen in hospital. Investigations included culture, serology, immunofluorescence antibody and urine antigen testing, with an increased use of PCR assays and expanded panels of pathogens in the post-vaccine study.241 and 160 children were enrolled in the pre- and post-vaccine studies, respectively (73% aged <5 years). Identification of a causative pathogen was higher post-vaccination (61%) than pre-vaccination (48.5%) (p=0.019). Rates of bacterial infections were not different between post- and pre-vaccine studies (17.5% versus 24%, p=0.258). Viral (31%) and mixed (12.5%) infections were found more often post-vaccination (19.5%, p=0.021) than pre-vaccination (5%, p=0.015). Rates of identified pneumococcal infections were comparable between pre- and post-vaccine studies (14.7% versus 17.4%, p=0.557). Diagnosis of pneumococcal infection post-vaccination improved when PCR was used compared to culture (21.6% versus 6%, p=0.0004). Serotypes included in PCV13 but not PCV7 were identified in 75% (18 out of 24) post-vaccination.Infection with nonvaccine pneumococcal serotypes continues to be a significant cause of pneumonia in children in the UK.

Publication metadata

Author(s): Elemraid MA, Sails AD, Eltringham GJA, Perry JD, Rushton SP, Spencer DA, Thomas MF, Eastham KM, Hampton F, Gennery AR, Clark JE, North East of England Paediatric Respiratory Infection Study Group

Publication type: Article

Publication status: Published

Journal: European Respiratory Journal

Year: 2013

Volume: 42

Issue: 6

Pages: 1595-1603

Print publication date: 01/12/2013

Online publication date: 18/04/2013

Acceptance date: 24/03/2013

Date deposited: 05/01/2015

ISSN (print): 0903-1936

ISSN (electronic): 1399-3003

Publisher: European Respiratory Society


DOI: 10.1183/09031936.00199112


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Funder referenceFunder name
0887X1-4479Pfizer Vaccines UK