Etiology of Pneumonia in a Pediatric Population with High Pneumococcal Vaccine Coverage. A Prospective Study

Background: Improved Childhood Immunizations Programs, especial ly the introduction of pneumococcal vaccination, better diagnostic methods and the importance of reduced antibiotic misuse, makes this a critical ti me to increase knowledge on the etiology of pediatric pneumonia. Our main objective was to identify the contribution of various microbiological species that causes pneumonia in previously healthy children and adolescents in a population with high pneumococcal conjugate vaccine coverage. Methods: This prospective, observational study enrolled pati ents with clinical and radiological signs of pneumonia over a 2-year period. Both in- and outpatients were included. Paired sera, nasopharyngeal PCR and bacterial cultures from blood and pleura were analyzed to detect potential viral and bacterial causative pathogens. Results: 265 cases of clinical and radiological verified pneumonia were identified. The pneumococcal vaccine coverage was 85%. We identified a causative pathogen in 84.2% of all cases; 63.4% with single viral etiology, 11.3% with pneumococcus and 7.5% with mycoplasma infection. Respiratory syncytial virus was the most common pathogen