Impact of PCV13 on community-acquired pneumonia by C-reactive protein and procalcitonin levels in children

Lévy, Corinne; Biscardi, Sandra; Dommergues, Marie Aliette; Dubos, François; Hees, Laure; Levieux, Karine; Aurel, M.; Minodier, Philippe; Zenkhri, Férielle; Cohen, Robert; Hau, Isabelle; Craiu, Irina; Gillet, Yves; Guen, Christèle Gras‐Le; Launay, Élise; Morin, Laurence; Lorrot, Mathie; Martinot, A.; Varon, Emmanuelle; Béchet, Stéphane; Angoulvant, François

doi:10.1016/j.vaccine.2017.06.057

Cited by 20 publications

(22 citation statements)

References 40 publications

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“…Cohen et al found that PCT was the best routinely available biomarker for predicting clinical response to beta-lactam treatment in children with CAP ( 21 ), again suggesting that PCT might be a surrogate marker of pneumococcal etiology. Our results confirm the potential usefulness of CRP and PCT in estimating the efficacy of PCVs among children ( 13 , 14 ), and determining the eligibility of children for clinical trials of CAP, as has been proposed for adults ( 22 ). The advantages of CRP compared to PCT are the availability of rapid point-of-care tests able to provide a result in ≤5 min ( 23 ), and its low cost.…”

Section: Discussionsupporting

confidence: 82%

“…Procalcitonin (PCT) was shown to be a predictor of bacteremia and disease severity in children with CAP ( 10 – 12 ). CRP and PCT are also used as surrogate markers of pneumococcal infection in studies evaluating the effectiveness of pneumococcal conjugate vaccines (PCVs) ( 13 , 14 ); confirming the association between routinely available biomarkers and bacteremia would further support their use as endpoints in PCV trials. In this large, prospective, multicenter study, we aimed at assessing the performance of four biomarkers (WBC, ANC, CRP, and PCT) to predict bacteremia in a population of children with CAP.…”

Section: Introductionmentioning

confidence: 90%

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Diagnostic Accuracy of Routinely Available Biomarkers to Predict Bacteremia in Children With Community-Acquired Pneumonia: A Secondary Analysis of the GPIP/ACTIV Pneumonia Study in France, 2009–2018

Dudognon

Lévy

Biscardi³

et al. 2021

Front. Pediatr.

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Objective(s): Blood cultures (BC), when performed in children seen in the emergency department with community-acquired pneumonia (CAP), are most of the time sterile. We described the diagnostic accuracy of white blood cells (WBC), absolute neutrophils count (ANC), C-reactive protein (CRP), and procalcitonin (PCT) to predict blood culture (BC) result in childhood CAP.Study Design: Secondary analysis of a prospective study carried out in eight pediatric emergency departments (France, 2009–2018), including children (≤15 years) with CAP. Analyses involved univariate comparisons and ROC curves.Results: We included 13,752 children with CAP. BC was positive in 137 (3.6%) of the 3,829 children (mean age 3.7 years) in whom it was performed, mostly with Streptococcus pneumoniae (n = 107). In children with bacteremia, ANC, CRP and PCT levels were higher (median 12,256 vs. 9,251/mm3, 223 vs. 72 mg/L and 8.6 vs. 1.0 ng/mL, respectively; p ≤ 0.002), but WBC levels were not. The area under the ROC curve of PCT (0.73 [95%CI 0.64–0.82]) was significantly higher (p ≤ 0.01) than that of WBC (0.51 [0.43–0.60]) and of ANC (0.55 [0.46–0.64]), but not than that of CRP (0.66 [0.56–0.76]; p = 0.21). CRP and PCT thresholds that provided a sensitivity of at least 90% were 30 mg/L and 0.25 ng/mL, respectively, for a specificity of 25.4 and 23.4%, respectively. CRP and PCT thresholds that provided a specificity of at least 90% were 300 mg/L and 20 ng/mL, respectively, for a sensitivity of 31.3 and 28.9%, respectively.Conclusions: PCT and CRP are the best routinely available predictive biomarkers of bacteremia in childhood CAP.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 90%

Diagnostic Accuracy of Routinely Available Biomarkers to Predict Bacteremia in Children With Community-Acquired Pneumonia: A Secondary Analysis of the GPIP/ACTIV Pneumonia Study in France, 2009–2018

Dudognon

Lévy

Biscardi³

et al. 2021

Front. Pediatr.

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“…Other vaccines, such as diphtheria, pertussis, Hib, meningococcal, influenza, measles and varicella, also have the potential to reduce antibiotic use and the development of antimicrobial resistance [10,24]. The full benefits of PCV vaccines include a reduction in hospital visits for acute otitis media, reduced incidences of community-acquired pneumonia (CAP), invasive pneumococcal disease (IPD), and pleural effusion, CAP-and IPD-associated hospitalisation in vaccinated and unvaccinated populations [25,26]. In addition, the incidence of any bacteraemia decreased from [ 100/ 100,000 children aged 3-36 months in 1998 to \ 20/100,000 children in 2014 [27].…”

Section: Indirect Benefits Of Vaccines and Vaccinationmentioning

confidence: 99%

Communicating Benefits from Vaccines Beyond Preventing Infectious Diseases

Chevalier-Cottin

Ashbaugh

Brooke³

et al. 2020

Infect Dis Ther

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Despite immunisation being one of the greatest medical success stories of the twentieth century, there is a growing lack of confidence in some vaccines. Improving communication about the direct benefits of vaccination as well as its benefits beyond preventing infectious diseases may help regain this lost confidence. A conference was organised at the Fondation Merieux in France to discuss what benefits could be communicated and how innovative digital initiatives can used for communication. During this meeting, a wide range of indirect benefits of vaccination were discussed. For example, influenza vaccination can reduce hospitalisations and deaths in older persons with diabetes by 45% and 38%, respectively, but the link between influenza and complications from underlying chronic non-communicable diseases such as diabetes is frequently underestimated. Vaccination can reduce antimicrobial resistance (AMR), which is growing, by reducing the incidence of infectious disease (though direct and indirect or herd protection), by reducing the number of circulating AMR strains, and by reducing the need for antimicrobial use. Disease morbidity and treatment costs in the elderly population are likely to rise substantially, with the ageing global population. Healthy ageing and life-course vaccination approaches can reduce the burden of vaccine-preventable diseases, such as seasonal influenza and pneumococcal diseases, which place a significant burden on individuals and society, while improving quality of life. Novel disease surveillance systems based on information from Internet search engines, mobile phone apps, social media, cloud-based electronic health records, and crowd-sourced systems, contribute to improved awareness of disease burden. Examples of the role of new techniques and tools to process data generated by multiple sources, such as artificial intelligence, to support vaccination programmes, such as influenza and dengue, were discussed. The conference participants agreed that continual efforts are needed from all stakeholders to ensure effective, transparent communication of the full benefits and risks of vaccination.

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“…This includes the duration of antibiotic therapy for children with AOM or group A Streptococcus pharyngitis as well as the use of biomarkers or rapid diagnostic tests to improve diagnostic performance and use of appropriate antibiotics for different infectious diseases. [8][9][10][11] Finally, the best proof of success was that pediatricians' behavior was correlated with the research they conducted. Particularly, our group, which promptly implemented the proposed recommendations, showed less prescription of antibiotics and greater vaccination coverage for their patients than other physicians who applied the recommendations later.…”

Section: From Antibiotic Treatment To Prevention With Vaccinesmentioning

confidence: 99%

Pediatric Ambulatory and Hospital Networks for Surveillance and Clinical Epidemiology of Community-Acquired Infections

Lévy¹,

Sage

Varon

et al. 2018

The Journal of Pediatrics

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Impact of PCV13 on community-acquired pneumonia by C-reactive protein and procalcitonin levels in children

Cited by 20 publications

References 40 publications

Diagnostic Accuracy of Routinely Available Biomarkers to Predict Bacteremia in Children With Community-Acquired Pneumonia: A Secondary Analysis of the GPIP/ACTIV Pneumonia Study in France, 2009–2018

Diagnostic Accuracy of Routinely Available Biomarkers to Predict Bacteremia in Children With Community-Acquired Pneumonia: A Secondary Analysis of the GPIP/ACTIV Pneumonia Study in France, 2009–2018

Communicating Benefits from Vaccines Beyond Preventing Infectious Diseases

Pediatric Ambulatory and Hospital Networks for Surveillance and Clinical Epidemiology of Community-Acquired Infections

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