BACKGROUND:Group A Streptococcus (GAS) causes a wide range of infections, with substantial morbidity and mortality associated with invasive infections and suppurative complications. The diagnostic accuracy of rapid antigen detection tests (RADTs) is well established in children with pharyngitis, but not in extrapharyngeal infections. OBJECTIVES:To evaluate the diagnostic accuracy of RADTs for identifying GAS in children with extrapharyngeal infections. METHODS:Systematic review of diagnostic test accuracy. PROTOCOL:CRD420251108689 (PROSPERO). DATA SOURCES:PubMed and Web of Science (inception to November 2025). STUDY ELIGIBILITY CRITERIA:Studies evaluating RADTs in children with suspected extrapharyngeal infections caused by GAS. PARTICIPANTS:Children (0-18 years). TEST: RADTs for GAS. REFERENCE STANDARD:Bacterial culture and PCR. ASSESSMENT OF RISK OF BIAS:Quality Assessment of Diagnostic Accuracy Studies-2. METHODS OF DATA SYNTHESIS:Bivariate random-effects meta-analysis of sensitivity and specificity. Heterogeneity was evaluated through prespecified subgroup analyses and meta-regression. Robustness of the results was assessed through sensitivity analyses. RESULTS:We included 16 studies (23 RADT evaluations; 1737 unique patients; 2610 test results). Methodological quality varied across studies, with only four studies judged to have an overall low risk of bias. RADTs had a summary sensitivity of 92% (95% CI: 89-94) and a summary specificity of 99% (95% CI: 96-100). Sensitivity was similar across studies, whereas specificity varied according to infection type (p = 0.043), infection invasiveness (p <0.001), and the reference standard used (p <0.001). Sensitivity analyses restricted to various study subsets yielded consistent results. DISCUSSION:This systematic review found high sensitivity and very high, but variable, specificity of RADTs for identifying GAS in children with extrapharyngeal infections, particularly in those with pleural empyema. These findings suggest that RADTs may have a role in various clinical scenarios beyond pharyngitis, particularly when rapid results directly influence clinical management, but further high-quality studies are needed to define their precise role in diagnostic pathways for each infection type.

CONTEXT:Nirsevimab was implemented in Europe and the United States in September 2023. While its effectiveness in preventing respiratory syncytial virus (RSV)-bronchiolitis has been demonstrated by real-life studies, its impact on mid-term child health, quality of life, and parental absenteeism remains unstudied. METHODS:Infants under 1-year with a first bronchiolitis episode were recruited through the OURSYN study involving 37 primary care pediatricians in France between 2021 and 2025 (pre-nirsevimab period: 02/2021-03/2023 and nirsevimab period: 09/2023-03/2025). RSV status was determined by antigenic nasopharyngeal testing. At day 15, parents reported symptoms, quality of life (PedsQL Infant), and work absenteeism. Their associations with (i) RSV status, (ii) period of inclusion, and (iii) nirsevimab immunization status among RSV-positive cases were assessed using multivariable logistic regression adjusted for confounders. RESULTS:Among 1870 bronchiolitis cases included, 637 (34.0%) occurred during the nirsevimab period and 812 (43.4%) were RSV-related. Over the study period, at day 15, RSV-cases had more feeding difficulties (aOR = 1.41 [1.06-1.88]), longer daycare absence (4.7 vs. 3.2 days), and more parental absenteeism (aOR = 1.61 [0.99-2.62]) compared to RSV-negative. The proportion of RSV-cases decreased during the nirsevimab period compared with the pre-nirsevimab period (47.1% vs. 35.7% P < .001). Bronchiolitis cases recruited during this period had shorter daycare absences (3.2 vs. 4.3 days). Among RSV-cases, immunized infants had lower risk of persistent fever (aOR = 0.14 [0.01-0.79]). CONCLUSION:This large prospective study provides the first evidence that the mid-term burden of RSV-bronchiolitis in infants may be reduced following the implementation of nirsevimab, with potential benefits for infant health, quality of life and parental absenteeism.

OBJECTIVE:To estimate the effectiveness of nirsevimab against respiratory syncytial virus (RSV)-associated acute otitis media (AOM) in ambulatory care. STUDY DESIGN:We conducted a test-negative design study, post hoc analysis using data from the prospective Oursyn study involving 37 primary care pediatricians across France from 2020 to 2025. Nasopharyngeal sampling for RSV was performed in infants younger than 1 year diagnosed with AOM during the first 2 RSV seasons with introduction of nirsevimab passive immunization (October 2023 to February 2024 and October 2024 to January 2025). The main outcome of the study was the detection of RSV status in infants with AOM. We performed a multivariable logistic regression with nirsevimab adjusted for age, sex, underlying chronic condition, prematurity, type of childcare, month, year, and geographic region of inclusion. Sensitivity analyses were performed as well. RESULTS:A total of 236 AOM events were included over the study period: 141 during the first season of nirsevimab implementation and 95 during the second season. Among infants with AOM, 41 (29.1%) and 15 (15.8%), respectively, tested positive for RSV. Nirsevimab-adjusted effectiveness was estimated to be 78.2% (95% CI 44.4-92.4) for the prevention of RSV-AOM in this sample. Sensitivity analyses found similar results. CONCLUSIONS:These findings highlight the broader protective effect of nirsevimab on complications of respiratory tract infections in infants. TRIAL REGISTRATION:NCT04743609.

We describe the characteristics of children hospitalized for coronavirus disease 2019 in France with a focus on the post-BA.1 Omicron period (February 2022–December 2023). We identified 3 main groups of children: those ≤90 days old (44.8%), older children with comorbidities (22.1%) and children with multisystem inflammatory syndrome (5.2%). Low vaccination coverage in these groups suggests that this burden could be alleviated with immunization.

Severe cardiovascular involvement is associated with mortality in multisystem inflammatory syndrome in children (MIS-C). This study aimed to test a previously published cardiogenic shock risk score at diagnosis of MIS-C and build a new screening tool in a larger pediatric cohort. The first score published in a single-center cohort (age > 8 years, time to diagnosis ≥ 6 days, and NT-proBNP at diagnosis ≥ 11.103 ng/L) was tested in a multicenter cohort of pediatric patients diagnosed with MIS-C from 2020 to 2023. In the multicenter cohort, the factors associated with the occurrence of cardiogenic shock were determined and a new score was built using a multivariate regression model. In 127 children with MIS-C, (median age [interquartile range] 8.6 [5.2; 11.5] years, 67 (53

OBJECTIVES: Most of the clinical and economic burden of Respiratory Syncytial Virus (RSV) in pediatric populations is concentrated among infants aged < 1 year. This study aimed to estimate the recent incidence, healthcare costs and rehospitalization risk associated with RSV-related hospitalizations in infants < 1 year of age in France. METHODS: The study analyzed the French National Hospital Database (PMSI) between January 1, 2016 and December 31, 2023. Outside of the classically defined epidemic season (October–March), RSV-related hospitalizations in infants were identified based on RSV-specific diagnosis codes and by both specific and non-specific RSV diagnosis codes during the epidemic season. Analyses were stratified by calendar months, by age in months and weeks for infants under 2 months. Lengths of stays (LOS), intensive care units (ICU) admissions, costs and rehospitalization rates were described. Rehospitalization rate was assessed using the Kaplan-Meier estimator. RESULTS: A total of 354,837 RSV-related hospitalizations were identified, representing an average of 44,355 per year, and a rate of 4.9 hospitalizations per 1,000 births. Overall, 76.4% occurred between November and February (epidemic peak), and 21.1% in September-October and March-April (transition months). ICU admission was observed in 27.2% of hospitalizations. The median (Q1–Q3) hospital and ICU LOS were 3.0 days (1.0–5.0) and 3.0 days (2.0–5.0), respectively. The mean (SD) hospital cost was €3,110 (€4,694), for an annual cumulative cost of €137.9 million. Younger infants had longer and costlier stays, with greater need for ICU. Infants younger than 3 months accounted for 46.5% of the hospitalizations, 58.5% of ICU stays and 54.9% of cumulative LOS. RSV-associated rehospitalization rates [95%CI] were 10.1% [10.0%–10.3%] and 11.7% [11.5%–11.9%] at three and 12 months, respectively. CONCLUSIONS: RSV infections are estimated to cause > 44,000 hospitalizations annually in infants in France, representing a total cost exceeding €130 million, annually. This study highlighted the impact of transitional months in RSV circulation. It also emphasized that the youngest patients (< 3 months) represent nearly 50% of the economic burden. To reduce RSV disease burden, it is essential to protect infants against RSV both inside and outside the classically defined epidemic season, especially in the first months of life. CLINICAL TRIAL: Not applicable.

Importance:New resistant mutations of respiratory syncytial virus type B (RSV-B) have been observed during the first year of implementation nirsevimab treatment. During the second season of implementation of nirsevimab treatment in France, RSV-B was predominant. Objectives:To assess and compare the effectiveness of nirsevimab treatment in preventing RSV bronchiolitis in pediatric emergency departments during the first and second seasons of implementation of treatment in France. Design, Setting, and Participants:This a multicenter test-negative case-control study included 636 infants younger than 1 year who received a diagnosis of a first bronchiolitis episode in 5 pediatric emergency departments in France during the 2 first seasons of implementation of nirsevimab treatment (from October 5, 2023, to February 29, 2024, and from October 15, 2024, to January 31, 2025) and underwent a nasopharyngeal test for RSV. Main Outcomes and Measures:The main outcome of the study was the RSV status of the bronchiolitis cases. Multivariable logistic regression was performed with nirsevimab as the explanatory variable, adjusted on age, sex, risk factors of bronchiolitis, type of childcare, month, and center of inclusion. Effectiveness was calculated for each season and compared using the likelihood ratio test. Subgroup analysis by age and severity as well as sensitivity analyses were performed. Results:The study included 636 patients with bronchiolitis (median age, 3.0 months [IQR, 1.4-5.0 months]; 333 boys [52.4%]). In both seasons, 162 of 636 patients (25.5%) were immunized with nirsevimab. During the first season of implementation, 273 of 384 patients (71.1%) tested positive for RSV; during the second season, 181 of 252 patients (71.8%) tested positive for RSV. The effectiveness of nirsevimab treatment against RSV bronchiolitis was estimated to be 83.2% (95% CI, 68.0%-91.4%) during the first season and 89.3% (95% CI, 77.8%-95.1%) during the second season; no statistically significant difference in effectiveness was found between the 2 seasons (P = .97). Subgroup and sensitivity analyses provided similar results. Conclusions and Relevance:In this test-negative case-control study of nirsevimab treatment, its effectiveness in reducing pediatric emergency department visits for RSV bronchiolitis during the second season of national immunization was high and comparable with that observed in the first season. Although RSV-B resistant strains had been recently identified, it did not appear to have important clinical consequences to date. Continued close monitoring of RSV epidemiology in the context of the widespread nirsevimab use remains essential.

Bronchiolitis is one of the leading reasons for paediatric emergency department (PED) visits. France was one of the few countries in the world to implement nirsevimab during winter 2023–2024 in order to reduce the burden of bronchiolitis each year. We conducted a test-negative design study, including all infants younger than 1, diagnosed with a first episode of bronchiolitis. We included all cases presenting to the PED of five university hospitals across France, between October 1, 2023, and February 29, 2024, and undergoing a nasopharyngeal sample for RSV testing. Case patients were the RSV-positive bronchiolitis and control patients the RSV-negative. As a follow-up, all parents were contacted by e-mail 15 days after inclusion. We included 383 bronchiolitis patients, of which 274 tested positive for RSV (75.2

BACKGROUND:Pneumococcal meningitis is a leading cause of bacterial meningitis and the most deadly pneumococcal disease in children worldwide. There is a paucity of evidence concerning the benefit of dexamethasone to prevent death in paediatric pneumococcal meningitis. We aimed to compare the effect of early adjunctive therapy with dexamethasone versus no dexamethasone on death in children with pneumococcal meningitis. METHODS:We did a non-randomised, comparative, multicentre, retrospective, quasi-experimental, propensity score-based study using data from a French national surveillance system of pneumococcal meningitis in children that collates data for 238 French paediatric wards working with 168 microbiology laboratories. We compared outcomes of adjunctive therapy with dexamethasone treatment (0·15 mg/kg every 6 h, for 4 days, per national guidelines) given within 12 h of antibiotic treatment versus no dexamethasone among all children aged 0-17 years with confirmed pneumococcal meningitis who had been hospitalised in one of the participating centres between Jan 1, 2005, and Nov 1, 2022. The primary outcome was 30-day all-cause death after hospital admission. The main propensity score analysis was based on inverse probability treatment weighting (IPTW), allowing adjustment for initial severity and baseline characteristics. Sensitivity analyses, such as propensity score matching, were done to assess the robustness of the results. FINDINGS:Between Jan 1, 2005, and Nov 1, 2022, 1765 cases of pneumococcal meningitis were reported to the National Surveillance System of Paediatric Bacterial Meningitis. 534 were excluded from the analysis and 1231 were included, with a median age of 1·1 years (IQR 0·5-5·0, range 0-17·9). 495 (40%) of 1231 patients were female, 716 (58%) were male, and 20 (1%) were missing data for sex. 650 (53%) of 1231 children received dexamethasone and 581 (47%) children did not receive dexamethasone. 108 (9%) of 1231 patients died. Within 30 days of hospitalisation, 105 (9%) patients died, 36 (6%) of 650 in the dexamethasone group and 69 (12%) of 581 in the no dexamethasone group. After IPTW, the adjusted 30-day death rate was 6% in the dexamethasone group and 12% in the no dexamethasone group (marginal odds ratio 0·39, 95% CI 0·23-0·65). All sensitivity analyses gave similar results. INTERPRETATION:Adjunctive dexamethasone within 12 h of starting antibiotic treatment was associated with a reduced 30-day risk of death in children hospitalised with pneumococcal meningitis. Our findings support the use of dexamethasone to reduce the risk of death in paediatric pneumococcal meningitis. FUNDING:Pfizer, ACTIV, and National Institute of Health and Medical Research (Inserm) Centre.

Following non-pharmaceutical interventions (NPI) lifting in 2021, an important surge in childhood lower respiratory tract infections (LRTI) was reported in several countries, raising major concerns about the middle-term consequences of such interventions. Whether this recent upsurge overwhelms the initial benefit of NPI remains unknown. We conducted an interrupted time-series analysis based on exhaustive national surveillance systems. All hospitalisations from January 2015 to March 2023 and all ambulatory visits for LRTI from a network of 110 paediatricians from June 2017 to March 2023 were included. The main outcome was the monthly incidence of children hospitalised for LRTI per 100,000 over time, assessed by a seasonally adjusted quasi-Poisson regression model. We included 845,047 hospitalisations. The incidence of hospitalisation for LRTI significantly decreased during the NPI period (− 61.7

After implementation of nirsevimab in 2023 in France as compared with 2022-2023, we found a 52.7%, 95% CI [46.4-58.9]) decrease in all-cause bronchiolitis in children <3 months with the lowest number of bronchiolitis cases in this population since 2017.

Les connaissances sur les pathologies infectieuses et leurs traitements évoluent constamment. De nouveaux agents infectieux sont régulièrement découverts, essentiellement du fait de l’évolution des techniques d’identification notamment grâce au développement de la biologie moléculaire et de la spectrométrie de masse. Les modifications de l’épidémiologie des maladies infectieuses ne sont pas toujours explicables mais plusieurs facteurs jouent un rôle important comme l’histoire naturelle des maladies, l’impact des vaccinations, mais aussi l’usage trop souvent excessif et irrationnel des antibiotiques. La résistance aux antibiotiques est reconnue comme un des défis majeurs pour l’humanité d’autant plus que peu de nouvelles molécules ont été mises sur le marché ces dernières d’années. Celles-ci sont réservées à des infections graves dues à des bactéries résistantes aux autres antibiotiques et ne devraient pouvoir être prescrites que par des infectiologues formés à leur utilisation. La rationalisation de l’antibiothérapie est donc un des éléments clés pour réduire la résistance aux antibiotiques et la dissémination des bactéries résistantes. Dans ce guide, pour chaque situation clinique seront précisés, la ou les cibles bactériennes du traitement antibiotique, le choix antibiotique préférentiel, les alternatives thérapeutiques. Des commentaires concernant le diagnostic et le traitement de l’infection seront ajoutés si nécessaire.

Depuis près d’un demi-siècle, de nombreuses études ont démontré la valeur des paramètres pharmacocinétiques/pharmacodynamiques (PK/PD) sériques pour prédire l’éradication bactérienne ou le succès thérapeutique, d’abord dans différents modèles animaux, puis chez l’homme. Ces paramètres sont désormais la pierre angulaire du développement des antibiotiques, de la détermination de la posologie et de l’intervalle d’administration, ainsi que pour l’établissement des concentrations minimales inhibitrices (CMI) dites « critiques » permettant de classer les souches dans la zone sensible ou résistante à un antibiotique donné. Les premières études qui ont conduit à la détermination de paramètres PK/PD prédictifs ont utilisé des modèles animaux dans lesquels les CMI des antibiotiques contre la souche infectante étaient connues, ainsi que les concentrations sériques à différents moments après l’administration. Dans tous ces modèles, la forme libre de l’antibiotique, qui correspond le plus souvent à la forme active, semblait mieux corrélée à l’efficacité que la concentration totale. Depuis, les données fournies par ces modèles animaux ont été confirmées dans diverses infections rencontrées en pratique clinique : infections respiratoires hautes et basses, bactériémies, infections de la peau et des tissus mous, infections intra-abdominales, infections osseuses et articulaires acquises dans la communauté. Pour d’autres infections (osseuses ou des voies urinaires supérieures), sans avoir obtenu le même niveau de preuve, il semble indispensable de prendre en compte les paramètres PK/PD sériques. Dans le cas d’infections de tissus dans lesquels les antibiotiques diffusent mal (liquide céphalorachidien, œil…) et pour les infections de prothèses, les paramètres PK/PD locaux sont les plus prédictifs. Le choix des antibiotiques, ainsi que les doses journalières et la fréquence d’administration sont largement influencés par les paramètres PK/PD. Ils doivent être particulièrement bien connus des infectiologues et des pédiatres travaillant dans les services de soins intensifs pour une prise en charge optimale des patients infectés par des souches bactériennes moins sensibles ou présentant des caractéristiques susceptibles de modifier la pharmacocinétique des médicaments (mucoviscidose, drépanocytose, insuffisance rénale, infections sévères, etc.). En effet, pour ces patients, en particulier lorsque l’infection concerne des souches résistantes aux antibiotiques, la prescription ne peut pas être uniquement basée sur la médecine factuelle en raison de la relative rareté de ces situations. Par ailleurs, la prescription doit tenir compte des caractéristiques pharmacocinétiques et pharmacodynamiques des molécules administrées.

Depuis le début des années 1990, la résistance des pneumocoques aux antibiotiques a augmenté considérablement, devenant une question majeure de santé publique dans le monde et en France. Elle touche particulièrement les sérotypes de pneumocoques les plus fréquemment portés, et varie en fonction des pathologies, de l’âge, des régions et des β-lactamines prescrites. Cet article expose les différents facteurs pouvant influencer l'antibiorésistance ainsi que l’évolution de la résistance aux β-lactamines et aux macrolides des pneumocoques isolés dans le microbiote rhinopharyngé des enfants présentant une otite moyenne aiguë (OMA). © 2024 L'Auteur(s). Publié par Elsevier Masson SAS.

Using multiple national surveillance systems, we found an increase in the incidence of invasive pneumococcal disease during after the relaxation of non-pharmaceutical interventions against COVID-19, which strongly varied by age. Age groups with higher incidence of respiratory syncytial virus and influenza also experienced higher increase in invasive pneumococcal disease incidence, with no change in pneumococcal carriage.

Objective: To assess the burden of respiratory syncytial virus (RSV)-related bronchiolitis in primary care and at 15 days and 6 months after a primary care visit. Study Design: In this test-negative study, children <2 years old with a first episode of bronchiolitis were prospectively enrolled by 45 ambulatory pediatricians in France from February 2021 to April 2023. RSV was assessed with a rapid antigen detection test. The burden of the disease was assessed with a questionnaire, including quality of life (PedsQL 1.0 Infant Scales), at 15-day and 6-month follow-up. Children with a positive RSV test result (RSV+) were compared to those with a negative test result (RSV-). Results: Among the 1591 children enrolled, 750 (47.1%) were RSV+. At 15 days follow-up (data availability: 69%), as compared with RSV- children, RSV+ children more frequently had fever (20.5% vs. 13.7%, P = 0.004) and decreased food intake (27.0% vs. 17.4%, P < 0.001) during the last 3 days. They had higher rates of hospitalization (11.8% vs. 5.8%, P < 0.001), childcare absenteeism (83.5% vs. 66.1%, P < 0.001) and parents who had to stop working to care for them (59.1% vs. 41.0%, P < 0.001) as well as lower quality of life (median PedsQL score 76.2 vs. 78.4, P = 0.03). At 6 months (data availability: 48.5%), the 2 groups did not differ in proportion of medical attendance, hospitalization, antibiotic treatment or quality of life. Conclusion: RSV+ children experienced much more severe disease and follow-up family and societal burden than RSV- children. These data may be used as baseline data as RSV prophylaxis is about to be implemented.

BACKGROUND: Acute chest syndrome (ACS) is a life-threatening complication of sickle cell disease (SCD). Although respiratory pathogens are frequently detected in children with ACS, their respective role in triggering the disease is still unclear. We hypothesized that the incidence of ACS followed the unprecedented population-level changes in respiratory pathogen dynamics after COVID-19-related nonpharmaceutical interventions (NPIs). RESEARCH QUESTION: What is the respective role of respiratory pathogens in ACS epidemiology? STUDY DESIGN AND METHODS: This study was an interrupted time series analysis of patient records from a national hospital-based surveillance system. All children aged < 18 years with SCD hospitalized for ACS in France between January 2015 and May 2022 were included. The monthly incidence of ACS per 1,000 children with SCD over time was analyzed by using a quasi-Poisson regression model. The circulation of 12 respiratory pathogens in the general pediatric population over the same period was included in the model to assess the fraction of ACS potentially attributable to each respiratory pathogen. RESULTS: Among the 55,941 hospitalizations of children with SCD, 2,306 episodes of ACS were included (median [interquartile range] age, 9 [5-13] years). A significant decrease was observed in ACS incidence after NPI implementation in March 2020 (-29.5%; 95% CI, -46.8 to -12.2; P = .001) and a significant increase after lifting of the NPIs in April 2021 (24.4%; 95% CI, 7.2 to 41.6; P = .007). Using population-level incidence of several respiratory pathogens, Streptococcus pneumoniae accounted for 30.9% (95% CI, 4.9 to 56.9; P = .02) of ACS incidence over the study period and influenza 6.8% (95% CI, 2.3 to 11.3; P = .004); other respiratory pathogens had only a minor role. INTERPRETATION: NPIs were associated with significant changes in ACS incidence concomitantly with major changes in the circulation of several respiratory pathogens in the general population. This unique epidemiologic situation allowed determination of the contribution of these respiratory pathogens, in particular S pneumoniae and influenza, to the burden of childhood ACS, highlighting the potential benefit of vaccine prevention in this vulnerable population.

OBJECTIVES:We aimed to describe cases of acute bacterial meningitis (ABM) without cerebrospinal fluid (CSF) pleocytosis and the clinical and biological characteristics of affected children. METHODS:We analyzed results of a nation-wide population-based prospective surveillance study of acute ABM in children aged 3 months to 15 years in France. Absence of CSF pleocytosis was defined as CSF leukocyte count ≤5/mm3. RESULTS:We included 4754 cases of acute ABM from 2001 to 2022: 173 patients (3.6%) did not have CSF pleocytosis. ABM cases without CSF pleocytosis were mainly related to meningococcus (70% vs 44% with CSF pleocytosis, P <0.001). When performed in CSF with normal leukocyte count, Gram staining results were positive for 33%, culture for 80%, polymerase chain reaction results for 41%, and antigen detection for 20% of cases. Case fatality rate was higher for cases without than those with CSF pleocytosis (18% vs 6%, P <0.001). On multivariate analysis, absence of CSF pleocytosis was associated only with seizures before hospital arrival (adjusted odds ratio 2.3, 95% confidence interval 1.2-4.6, P <0.01). CONCLUSIONS:ABM without CSF pleocytosis is infrequent but not exceptional, particularly in children with seizures before hospital arrival. Extended vaccination against meningococcus could prevent this clinical form with a high case fatality rate.

L'introduction des vaccins conjugués contre le pneumocoque (VPC) au début des années 2000 a eu un impact majeur en termes de santé publique, tant en ce qui concerne l'incidence des infections que sur les prescriptions d'antibiotiques. Rapidement adopté aux États-Unis avec une efficacité remarquable, le VPC 7-valent a ensuite été introduit en Europe et au Royaume-Uni. En France, l'implémentation ayant été plus progressive, l'impact de cette vaccination a été moins flagrant en raison d'un remplacement sérotypique survenant rapidement malgré l'efficacité sur les sérotypes vaccinaux.Nous présentons ici des résultats d'efficacité en France, issus d’études comportant des séries chronologiques, concernant différentes pathologies : méningites à pneumocoque, infections invasives à pneumocoque, pneumonies et pleuropneumopathies, otites moyennes aiguës ainsi que sur les infections invasives chez l'adulte.© 2024 L'Auteur(s). Publié par Elsevier Masson SAS.