An Epidemiological Investigation of a Sustained High Rate of Pediatric Parapneumonic Empyema: Risk Factors and Microbiological Associations

Parapneumonic Effusion in Children

“…12 In terms of pneumococcal serotypes, type 1 and 19A displayed strong associations with pneumococcal PPE and empyema worldwide. 16,26 In the United States, serotype 3 589917C PJXXX10.1177/0009922815589917Clinical PediatricsHendaus and Janahi was the most frequent cause of pneumococcal necrotizing pneumonia and serotype 1 was the most prevalent in uncomplicated pneumococcal pneumonia. 32 In Taiwan, serotypes 14 and 3 were the most common serotypes causing complicated pneumococcal pneumonia.…”

“…21,25 Two independent studies showed that all pneumococcal serotype 1 isolates were penicillin susceptible in children with PPE. 16,25 However, 70% of serotype 14 isolates were penicillin resistant. 25 Furthermore, the Centers for Disease Control and Prevention reported an increased number of cases in children caused by antimicrobial resistance pneumococcal serotype (19A) in the United States.…”

Increased paediatric hospitalizations for empyema in Australia after introduction of the 7-valent pneumococcal conjugate vaccine

“…[10][11][12][13][14][15][16][17] Because up to 90% of these cases have been caused by bacterial serotypes not included in the PCV7, [10][11][12] some fear that empyema may have emerged as a "replacement disease", i.e. disease produced by non-vaccine-related serotypes that have become predominant.…”

Potential Impact of Conjugate Vaccine on the Incidence of Invasive Pneumococcal Disease among Children in Scotland

“…Initial studies have been carried out to compare the molecular epidemiology of the pneumococcus in the United States prior to vaccine administration (17,39) with that immediately following vaccine administration (7,39). These studies reveal that the use of PCV7 has significantly reduced the burden of pneumococcal disease in young children (5,6,8,39).…”