Peer-reviewed article
Impact of Pneumococcal Vaccination on the Occurrence of Complicated Pneumonia in Children: A Retrospective Analysis.
Katarina Milosevic, Jasna Kalanj, Nadja Cukanovic, Luka Zekovic, Vesna Selakovic et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether pneumococcal vaccination protects children from serious complications of pneumonia. Researchers reviewed medical records of 69 children treated in Belgrade between 2019 and 2024, comparing outcomes between vaccinated and unvaccinated children. Unvaccinated children experienced significantly more severe complications like empyema and lung abscess, and spent longer in hospital. Vaccination was found to be a strong independent protective factor against these serious complications.
Key points
- Pleuropneumonia and pleural effusion were the most frequent complications, while empyema and lung abscess were the most severe
- Empyema and lung abscess occurred significantly more often in unvaccinated children (p = 0.0054 and p = 0.0027)
- Vaccination was an independent protective factor against empyema (adjusted OR = 0.19, 95% CI 0.06-0.61)
- Vaccination showed strong protective effects against empyema (OR = 0.24) and lung abscess (OR = 0.04)
- Unvaccinated children had significantly longer hospital stays, indicating more severe clinical course
Limitations
This is a retrospective analysis from a single hospital in Serbia, so findings may not generalise to other populations or healthcare settings. The small sample size of 69 children limits statistical power to detect all associations.
Abstract
Complicated community-acquired pneumonia (cCAP) remains a major cause of morbidity in children. Although pneumococcal conjugate vaccines (PCVs) have reduced invasive disease, severe complications such as empyema and lung abscess persist. A retrospective analysis was conducted on 69 children treated at the University Children's Hospital Belgrade between 2019 and 2024. Data included demographic characteristics, pneumococcal vaccination status, and radiologically confirmed complications. Patients were classified by residence and vaccination status. Statistical analysis included chi-square (χ2) tests, odds ratios (ORs) with 95% confidence intervals, and multivariable logistic regression. Pleuropneumonia and pleural effusion were the most frequent complications, while empyema and lung abscess were the most severe. Both occurred significantly more often in unvaccinated children (p = 0.0054 and p = 0.0027). Multivariable analysis confirmed vaccination as an independent protective factor against empyema (adjusted OR = 0.19, 95% CI 0.06-0.61). No significant regional differences were observed after accounting for vaccination status. Vaccination showed a strong protective effect against empyema and lung abscess (OR = 0.24 and 0.04, respectively). Unvaccinated children had significantly longer hospital stays, indicating a more severe clinical course. Prolonged hospitalization was associated with intensified antibiotic therapy, reflecting underlying disease severity. Lack of pneumococcal vaccination is strongly associated with severe complications in children with cCAP. Maintaining high PCV coverage remains essential, alongside early recognition and timely management of pleural disease.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
Problem
Severe complications of community-acquired pneumonia (such as empyema and lung abscess) in children
- Intervention
- Pneumococcal conjugate vaccination (PCV)
- Population
- Children treated at University Children's Hospital Belgrade, 2019-2024 (69 children total)
Key finding
Empyema occurred significantly more often in unvaccinated children (p = 0.0027)