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Pediatric osteoarticular infections caused by Streptococcus pneumoniae before and after the introduction of the heptavalent pneumococcal conjugate vaccine

European Journal of Clinical Microbiology & Infectious Diseases volume 31, pages 2773–2781 (2012)Cite this article

Abstract

Streptococcus pneumoniae is an uncommon cause of osteoarticular infections (OAI) in children. The objective of this study was to investigate the clinical and laboratory characteristics of pneumococcal OAI before and after the introduction of the heptavalent pneumococcal conjugate vaccine (PCV7). Data were retrospectively collected from children aged <16 years who were hospitalized for pneumococcal OAI between 1997 and 2007 in four Parisian teaching hospitals. Forty-three children were included (32 with arthritis and 11 with osteomyelitis) and the median age of these children was 12.5 months (range 3 months to 14 years). Serotypes were available for 19/43 strains (44 %) from 1997 onwards and for 12/13 strains (92 %) from 2005 onwards. Seven unvaccinated children were infected with vaccine serotypes and we observed only one vaccine failure. After the introduction of PCV7, we noted an increase in short-term complications and the emergence of serotype 19A, which was penicillin-intermediate in 86 % of cases. After PCV7 introduction, serotype 19A was the most frequent serotype implicated in pediatric pneumococcal OAI. The 13-valent pneumococcal conjugate vaccine introduced in France in June 2010 should cover the emerging serotype.

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Acknowledgments

We thank Philip Bastable for the editorial assistance and Emmanuelle Varon (Centre National de Référence des Pneumocoques, Paris) for serotyping the pneumococcal strains. We thank the physicians for their participation in this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Affiliations

  1. General Pediatric Unit, Hôpital Robert Debré APHP, Univ Paris Diderot, Sorbonne Paris Cité, EA 3105, F-75019, Paris, France

    C. Lemaître & M. Lorrot

  2. Microbiology Unit, Hôpital Necker Enfants Malades APHP, Faculté Paris Descartes, Paris, France

    A. Ferroni

  3. Microbiology Unit, Hôpital Robert Debré APHP, Univ Paris Diderot, Sorbonne Paris Cité, EA 3105, F-75019, Paris, France

    C. Doit & E. Bingen

  4. Microbiology Unit, Hôpital Armand Trousseau APHP, Université Paris 6, Paris, France

    H. Vu-Thien

  5. Pediatric Orthopaedics Unit, Hôpital Necker Enfants Malades APHP, Faculté Paris Descartes, Paris, France

    C. Glorion

  6. Microbiology Unit, Hôpital Cochin APHP, Faculté Paris Descartes, Paris, France

    J. Raymond

  7. Pediatric Orthopaedics Unit, Hôpital Armand Trousseau APHP, Université Paris 6, Paris, France

    P. Mary

  8. Pediatric Orthopaedics Unit, Hôpital Necker Enfants Malades, APHP, Faculté Paris Descartes, Paris, France

    P. Wicart

  9. Pediatric Orthopaedics Unit, Hôpital Robert Debré APHP, Univ Paris Diderot, Sorbonne Paris Cité, EA 3105, F-75019, Paris, France

    B. Ilharreborde

  10. Service de Pédiatrie Générale, Hôpital Robert-Debré, 48 boulevard Sérurier, 75395, Paris Cedex 19, France

    M. Lorrot

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  1. C. Lemaître
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  2. A. Ferroni
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  3. C. Doit
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  4. H. Vu-Thien
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  10. B. Ilharreborde
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  11. M. Lorrot
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Lemaître, C., Ferroni, A., Doit, C. et al. Pediatric osteoarticular infections caused by Streptococcus pneumoniae before and after the introduction of the heptavalent pneumococcal conjugate vaccine. Eur J Clin Microbiol Infect Dis 31, 2773–2781 (2012). https://doi.org/10.1007/s10096-012-1627-5

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Keywords

  • Osteomyelitis
  • Septic Arthritis
  • Invasive Pneumococcal Disease
  • Cefpodoxime
  • Pneumococcal Meningitis