Clinical manifestations, serotype distribution, and incidence of pediatric invasive pneumococcal disease in Catalonia (Spain), 2018-2022.
Level 4 - case-series / case-control
Prospective hospital-based observational case series without a control group
PubMed 40316860 · doi:10.1007/s00431-025-06137-1
What was done
A 5-year prospective multicenter observational study was conducted from 2018 to 2022 across three major pediatric hospitals in Catalonia, Spain. Researchers analyzed clinical manifestations, epidemiology, serotype distribution, and incidence trends in children up to 18 years of age hospitalized with invasive pneumococcal disease (IPD), and assessed theoretical coverage of newer conjugate vaccines (PCV15 and PCV20).
What was found
A total of 220 IPD episodes were identified (median age 33.0 months, range 0–209). IPD incidence fell by 60.6% during the early pandemic period (2020–2021) compared to pre-pandemic years (2018–2019; p < 0.001), but returned toward baseline in 2022 (no significant difference vs. 2018). The most common diagnoses were pneumonia (61.8%), meningitis (14.5%), and bacteremia without focus (13.2%). Serotype 3 was the leading cause of IPD (35.1%) and was associated with complicated pneumonia (84.7%) and vaccine failure (73.6%). Overall, PCV13 serotypes accounted for 45.4% (93/205 serotyped), PCV15 for 47.3% (97/205), and PCV20 for 64.4% (132/205).
Why it matters
Serotype 3 continues to drive severe pediatric pneumococcal disease and vaccine failure despite PCV13 use. Moving to broader conjugate vaccines like PCV20 could cover roughly two-thirds of circulating pediatric IPD serotypes in this population.
Limits
The study was confined to hospitalized children at three regional hospitals in Catalonia, which may overrepresent severe disease. Real-world clinical effectiveness of PCV15 and PCV20 was not directly measured, only theoretical serotype coverage.
Cited by
- supports Pneumococcus infection can cause meningitis and pneumonia.