CLINICAL AND MICROBIOLOGICAL CHAR ACTERISTICS OF PEDIATRIC PATIENTS HOSPITALIZED FOR PNEUMOCOCCAL PNEUMONIA BEFORE AND AFTER THE INTRODUCTION OF PNEUMOCOCCAL CONJUGATE VACCINES

The clinical and microbiological characteristics of pneumococcal pneumonia in children hospitalized in Lima were analyzed, before and after the introduction of pneumococcal conjugate vaccines (PCV). We reviewed cases that occurred between 2006-2019, in the pre-PCV7 (2006-2008), post-PCV7 (2009-2011) and post-PCV13 (2016-2019) periods. Of 128 patients with positive cultures (92 blood and 36 pleural fluid), most were infants in the pre-PCV7 (77.1%) and post-PCV7 (43.3%) studies, while in the post-PCV13 study they were mostly preschoolers (62%). We found an increase in complicated pneumonia cases from 14.6% to 72% and an increase in serotype 19A (6.3% to 68%). The most frequent sequence type was ST320 (31 isolates). Resistance to penicillin and ceftriaxone was low (6% and 2%, respectively), although higher in empyema (21.4% and 14.3%, respectively). Resistance to azithromycin increased from 27% to 92%. Penicillin remains the antibiotic of choice for the treatment of uncomplicated pneumococcal pneumonia in Lima.