Pediatric case of septic arthritis due to Streptococcus pneumoniae serotype 19A

In recent years, the incidence of pediatric septic arthritis caused by Streptococcus pneumoniae has been quite low. The pneumococcal conjugate vaccine PCV10 is the available vaccine included in the Bulgarian national immunization program. PCV10 reduces the incidence of invasive diseases, but non-vaccinal serotypes like 19A, the etiologic agent of the case of septic arthritis reported herein in a 3-year-old boy. The synovial fluid was positive for S. pneumoniae. The patient was treated with vancomycin during hospitalization and trimetho-prim/sulfamethoxazole was recommended for at-home treatment. The isolate was sub-jected to latex agglutination, antimicrobial susceptibility testing, PCR detection for macrolide-resistance genes, and MLST. The strain revealed ST695 and a genotype previ-ously associated with vaccine serotype 4. The incidence of pneumococcal infections caused by capsule-switching events and non-PCV10 serotypes is expected to increase.(c) 2023 Sociedade Brasileira de Infectologia. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)