Department of Pediatrics, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, 693-8555, Shimane, Japan.
Department of Bacteriology I, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, 162-8640, Tokyo, Japan.
BMC Pediatr. 2021 Jan 4;21(1):8. doi: 10.1186/s12887-020-02465-3.
Invasive pneumococcal disease (IPD) is defined by the detection of Streptococcus pneumoniae on culture from samples obtained from a normally sterile site. Pneumococcal conjugate vaccines (PCV) have been developed for the prevention of IPD that is caused by highly virulent serotypes. Despite the effective reduction of IPD caused by vaccine serotypes after the introduction of PCV, there has been a rapid increase in the incidence of IPD caused by non-vaccine serotypes, and serotype replacement has become a global issue.
We report a previously healthy 4-month-old girl presenting with a large subcutaneous abscess caused by S. pneumoniae, identified as non-vaccine serotype 28F. The patient had received routine vaccination, including PCV vaccination. After the incision and drainage of the subcutaneous abscess, the patient was treated with antibiotics. She was discharged on Day 7 of hospitalization without any residual sequelae.
Subcutaneous abscess is a common pediatric skin and soft tissue infection, whereas pneumococcal subcutaneous abscesses are quite rare. As the pneumococcal serotype 28F caused a subcutaneous abscess, this serotype possibly has a high virulence. The incidence of IPD caused by non-vaccine serotypes, such as 28F, is expected to increase in the future. The consolidation of international data on pneumococcal serotypes is important for the development of novel PCV.
侵袭性肺炎球菌病 (IPD) 的定义是从正常无菌部位采集的样本中培养出肺炎链球菌。已开发出肺炎球菌结合疫苗 (PCV) 来预防由高毒力血清型引起的 IPD。尽管在引入 PCV 后，由疫苗血清型引起的 IPD 得到了有效减少，但由非疫苗血清型引起的 IPD 的发病率迅速上升，血清型转换已成为全球性问题。
我们报告了一例先前健康的 4 个月大女孩，因肺炎链球菌引起的大皮下脓肿就诊，该血清型为非疫苗血清型 28F。该患者已接受常规疫苗接种，包括 PCV 疫苗接种。在进行皮下脓肿切开引流后，患者接受了抗生素治疗。她在住院第 7 天出院，没有任何后遗症。
皮下脓肿是一种常见的儿科皮肤和软组织感染，而肺炎球菌性皮下脓肿则较为罕见。由于血清型 28F 引起了皮下脓肿，该血清型可能具有较高的毒力。未来，预计由非疫苗血清型（如 28F）引起的 IPD 的发病率将会增加。国际间对肺炎球菌血清型数据的整合对于新型 PCV 的开发非常重要。
