Document Type

Article

Publication Date

6-26-2025

Identifier

DOI: 10.1371/journal.pone.0327046; PMCID: PMC12200735

Abstract

BACKGROUND: Non-pharmaceutical interventions to mitigate the spread of SARS-CoV-2 were implemented across the United States in 2020. These public health measures might influence pneumococcal colonization in younger children and their subsequent risk of invasive pneumococcal disease. Our objective was to evaluate pneumococcal colonization rates in children ≤ 5 years of age with and without respiratory symptoms during the first 12 months of SARS-CoV-2 pandemic (April 2020 - March 2021).

STUDY DESIGN: This is a retrospective cross-sectional study evaluating pneumococcal colonization rates, density and serotype distribution across three study periods (April-July [Period 1], August-November [Period 2] and December-March [Period 3]) after implementation of non-pharmaceutical interventions in Kansas City, Missouri. Children aged ≤5 years with and without respiratory symptoms seeking care at Children's Mercy Kansas City hospital system with a residual standard of care nasal mid-turbinate sample were included. The odds of pneumococcal colonization across study periods were calculated using multivariable logistic regression.

RESULTS: A total of 311 children met inclusion criteria (126 symptomatic and 185 asymptomatic). The overall pneumococcal colonization (23% vs. 13%, p = 0.03) and SARS-CoV-2 positivity (34.1% vs. 17.8%, p = 0.001) rates were higher in symptomatic children than in asymptomatic children. The odds of pneumococcal colonization of symptomatic (Period 2: OR 1.09; 95% CI 0.33-3.64, and Period 3: OR 0.46; 95% CI 0.13-1.59) and asymptomatic (Period 2: OR 0.55; 95% CI 0.18-1.7, and Period 3: OR 0.37; 95% CI 0.11-1.2) children did not statistically differ across study periods. Pneumococcal colonization density was also not different across study periods among study groups. Overall, non-PCV15, non-PCV20 serotypes were the most frequently identified serotypes (56.8%).

CONCLUSIONS: Pneumococcal colonization rates and density did not significantly change across study periods as adherence to non-pharmaceutical interventions gradually relaxed during the first year of the SARS-CoV-2 pandemic.

Journal Title

PLoS One

Volume

20

Issue

6

First Page

0327046

Last Page

0327046

MeSH Keywords

Humans; COVID-19; Child, Preschool; Male; Female; Infant; Streptococcus pneumoniae; Cross-Sectional Studies; Pneumococcal Infections; Retrospective Studies; SARS-CoV-2; Missouri; Pandemics

PubMed ID

40569997

Keywords

COVID-19; Streptococcus pneumoniae; Cross-Sectional Studies; Pneumococcal Infections; Retrospective Studies; SARS-CoV-2; Missouri; Pandemics

Comments

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publisher's Link: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0327046

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