LymeScience (@lymescience.org)

The Evolving Epidemiology of Invasive Pneumococcal Disease in Australian Children: A Multicentre Retrospective Observational Study In Australia, high pneumococcal conjugate vaccine (PCV) coverage has been achieved, yet invasive pneumococcal disease (IPD) continues to cause a significant burden of disease. The epidemiology of IPD was altered by the nonpharmaceutical interventions (NPIs) used to control the coronavirus disease (COVID-19) pandemic. We aimed to analyze this impact on the clinical characteristics associated with IPD in Australian children.MethodWe systematically evaluated the clinical and microbiological characteristics of IPD in children (<18 years) presenting to 4 Australian children's hospitals 2 years before (2017–2018: prepandemic) and after (2021–2022: postpandemic) the implementation of NPIs to mitigate COVID-19. Case counts and proportions were used to compare clinical presentations.ResultsWe identified 220 cases of IPD: 116 in 2017–2018 and 104 in 2021–2022. Causative serotypes were available for 176 cases (80%), with serotype 3 most frequently identified (26% of serotyped IPD, 46/176). One-quarter of cases were due to serotypes included in newer PCVs. Postpandemic cases had a higher proportion of meningitis (13.5% vs 3.4%, P = .001) and test-confirmed associated viral infections (63.8% vs 36.2%, P = .008) compared to prepandemic cases. Children with viral co-infections were significantly more likely to have prolonged fevers (>14 days; 13% vs 1%, P = .001).ConclusionsAlternations in the prevalence of respiratory viral transmission influence the epidemiology and clinical presentation of IPD. Newer PCVs and the implementation of immunization programs that target viral pathogens associated with IPD may reduce the ongoing burden of IPD in children. https://academic.oup.com/ofid/article/doi/10.1093/ofid/ofag275/8704981?rss=1