Cases of pneumococcal pneumonia surged in 2022 and 2023. The bacterial infection attacks the lungs, causing air sacs to become inflamed and fill with fluid.
New findings published today by the American Academy of Pediatrics show that this post-COVID increase was largely driven by a specific subtype of the Streptococcus pneumoniae bacteria: Serotype 3 is associated with severe complications, including meningitis.
These findings are especially salient for young children, older adults, and those with weakened immune systems, as these groups have the highest risk.
Finding the culprit
There are more than 100 distinct subgroups of S pneumoniae, though most hospitals lack the laboratory capacity to determine which serotype is causing an infection.
However, the study found that among 190 kids with pneumococcal pneumonia from 2017 to 2023, serotype 3 infected 32% of patients.
Researchers note that serotype 3 was, "The only individual serotype with a significantly higher rate in 2022–2023 compared with 2018–2019." (Rate ratio, 3.0)
The findings don’t surprise the study's lead author, Eric E. Engstrom, MD, at Children's Hospital of The King's Daughters in Norfolk, Virginia. The pediatric infectious diseases specialist told CIDRAP News that he and other clinicians have noticed that more pneumococcal pneumonia patients are suffering from severe infections, which is indicative of Serotype 3.
Parents get impatient. Patients get impatient. And certainly, the providers get impatient.
Engstrom said these findings can inform clinical decisions because while patients with serotype 3 take longer to improve, this form of S pneumoniae responds well to common antibiotics, including penicillin.
"Parents get impatient. Patients get impatient. And certainly, the providers get impatient," he said.
But as the findings suggest, sometimes patience is the right course rather than prescribing broader, potentially more harmful antibiotics.