Impacto da Pandemia pelo Sars-Cov-2 nas Infecções por Streptococcus Pneumoniae em um Hospital Infantil Terciário do Sul do Brasil

Introduction/Objectives: Streptococcus pneumoniae remains a major etiological agent contributing to pediatric morbidity and mortality. The COVID-19 pandemic altered the behavior of infections in children, raising the need to assess possible changes in the profile of pneumococcal infections. This study evaluated the clinical, microbiological, and therapeutic characteristics of S. pneumoniae infections in children hospitalized in a tertiary center in Southern Brazil during the pre- and post-pandemic periods, aiming to identify the pandemic’s impact on these outcomes. Methods: This was a retrospective, observational, and analytical study including patients hospitalized for more than 24 hours with a positive culture for S. pneumoniae between January 2018 and December 2024. Clinical, epidemiological, microbiological, therapeutic, and outcome data were analyzed using descriptive statistics and the chi-square test (p60%). Vaccination records were scarce (9.2% overall; 2.4% post-pandemic). Antimicrobial resistance was present in 66% of isolates, mainly to Sulfamethoxazole-Trimethoprim (57%) and Clindamycin (56%), with no significant difference between periods. Pneumonia was the most frequent diagnosis (60.8%), with no relevant variation in infection site or length of stay. A trend toward greater severity was observed post-pandemic, with higher ICU admission rates (66.3% vs. 48.6%) and a greater proportion of hospitalizations longer than 15 days (51.8% vs. 43.2%). Conclusion: The study showed increased severity in the post-pandemic period, with longer hospitalizations and greater ICU need, possibly due to an “immunity debt,” reinforcing the importance of surveillance, appropriate management, and vaccination.