Büşra DEMİRCİ, Gülsüm İclal BAYHAN, Tuğba ERAT, Aysun YAHŞİ, Seval ÖZEN, Ahmet Yağmur BAŞ, Dilek ÇETİN, Bedia DİNÇ, Şerife Suna OĞUZ
Türkiye Çocuk Hastalıkları Dergisi - 2026;20(1):58-63
Objective: Invasive pneumococcal disease (IPD) is a rare but serious cause of neonatal sepsis associated with significant morbidity and mortality. Despite widespread pneumococcal conjugate vaccine (PCV) use in infants, neonates remain vulnerable due to lack of direct vaccination and potential vertical or horizontal transmission. This study aimed to characterize the clinical, laboratory, and microbiological features of neonatal IPD and to evaluate associated outcomes in this high-risk population. Material and Methods: We conducted a retrospective cross-sectional study of neonates (0-30 days old) diagnosed with IPD between September 2019 and April 2025. Diagnosis was confirmed by isolation of Streptococcus pneumoniae from sterile body fluids or PCR detection. Demographic, clinical, microbiological, and outcome data were analyzed. Results: Among 68 IPD cases, 12 neonates with pneumococcal bacteremia were identified; no meningitis or focal infections were observed. The cohort had equal sex distribution, mean gestational age of 35+/-3.8 weeks, and 33.3% had comorbidities. Early-onset sepsis (<=72 hours) accounted for 25% of cases, with the remainder presenting as late-onset sepsis (>72 hours). One neonate had concurrent SARS-CoV-2 infection. All patients survived; one preterm infant developed neurological sequelae attributable to pre-existing conditions. Antibiotic susceptibility testing showed reduced sensitivity to penicillin (20%) and ceftriaxone (16.7%), while vancomycin and linezolid remained highly effective. Conclusion: Neonatal invasive pneumococcal bacteremia, although uncommon, continues to pose clinical challenges, particularly due to evolving antimicrobial resistance. Our findings emphasize the importance of vigilant clinical monitoring and tailored antimicrobial therapy in this vulnerable population. Continued surveillance and prospective studies are warranted to assess the impact of maternal and early infant vaccination strategies on neonatal IPD prevention.
