{Reference Type}: Journal Article
{Title}: Necrotizing pneumonia in children: Report of 25 cases between 2008 and 2018 at a French tertiary care center.
{Author}: Cathalau M;Michelet M;Rancé A;Martin-Blondel G;Abbo O;Dubois D;Labouret G;Grouteau E;Claudet I;Ricco L;Roditis L;Mansuy JM;Simon S;Bréhin C;
{Journal}: Arch Pediatr
{Volume}: 31
{Issue}: 3
{Year}: 2024 Apr 13
{Factor}: 1.82
{DOI}: 10.1016/j.arcped.2023.12.004
{Abstract}: BACKGROUND: Necrotizing pneumonia (NP) is a serious and rare disease in children. Pediatric data on NP are limited and the impact of the 13-valent pneumococcal conjugate vaccine has been very poorly evaluated.
METHODS: We conducted a retrospective study at Toulouse University Hospital between 2008 and 2018. Children who presented with thin-walled cavities in the areas of parenchymal consolidation on imaging were included in the study.
RESULTS: The incidence of NP did not decrease during this period. Bacterial identification occurred in 56% of cases (14/25) and included six cases of Streptococcus pneumoniae, five of Staphylococcus aureus, two of Streptococcus pyogenes, and one of Streptococcus viridans. Streptococcus pneumoniae NP are more frequently associated with empyema/parapneumonic effusion compared to S. aureus NP (p = 0.02). Patients with S. pyogenes NP more often required volume expansion than did S. pneumoniae cases (p = 0.03). When comparing children born before and after implementation of the 13-valent pneumococcal conjugate vaccine, we identified a relative modification of the bacterial epidemiology, with an increase in the proportion of S. pyogenes NP and S. aureus NP and a decrease in the proportion of NP caused by S. pneumoniae.
CONCLUSIONS: Future studies are needed to assess the epidemiology of NP in children. Continued surveillance of identified pneumococcal serotypes is essential to document epidemiological changes in the coming years.