J G Liese1, C Schoen2, M van der Linden3, L Lehmann4, D Goettler4, S Keller4, A Maier4, F Segerer4, M A Rose5, A Streng4. 1. Department of Paediatrics, University Hospital of Würzburg, Würzburg, Germany. Electronic address: Liese_J@ukw.de. 2. Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany. 3. Department of Medical Microbiology, National Reference Centre for Streptococci, University Hospital RWTH Aachen, Aachen, Germany. 4. Department of Paediatrics, University Hospital of Würzburg, Würzburg, Germany. 5. Hospital St. Georg gGmbH, Leipzig, Germany.
Abstract
OBJECTIVES: Parapneumonic pleural effusions/empyema (PPE/PE) are severe complications of community-acquired pneumonia. We investigated the bacterial aetiology and incidence of paediatric PPE/PE in Germany after the introduction of universal pneumococcal conjugate vaccine (PCV) immunization for infants. METHODS: Children <18 years of age hospitalized with pneumonia-associated PPE/PE necessitating pleural drainage or persisting >7 days were reported to the German Surveillance Unit for Rare Diseases in Childhood between October 2010 and June 2017. All bacteria detected in blood or pleural fluid (by culture/PCR) were included, with serotyping for Streptococcus pneumoniae. RESULTS: The median age of all 1447 PPE/PE patients was 5 years (interquartile range 3-10). In 488 of the 1447 children with PPE/PE (34%), 541 bacteria (>40 species) were detected. Aerobic gram-positive cocci accounted for 469 of 541 bacteria detected (87%); these were most frequently Streptococcus pneumoniae (41%), Streptococcus pyogenes (19%) and Staphylococcus aureus (6%). Serotype 3 accounted for 45% of 78 serotyped S. pneumoniae strains. Annual PPE/PE incidence varied between 14 (95%CI 12-16) and 18 (95%CI 16-21) PPE/PE per million children. Incidence of S. pneumoniae PPE/PE decreased from 3.5 (95%CI 2.5-4.6) per million children in 2010/11 to 1.5 (95%CI 0.9-2.4) in 2013/14 (p 0.002), followed by a re-increase to 2.2 (95%CI 1.5-3.2) by 2016/17 (p 0.205). CONCLUSIONS: In the era of widespread PCV immunization, cases of paediatric PPE/PE were still caused mainly by S. pneumoniae and, increasingly, by S. pyogenes. The re-increase in the incidence of PPE/PE overall and in S. pneumoniae-associated PPE/PE indicates ongoing changes in the bacterial aetiology and requires further surveillance.
OBJECTIVES:Parapneumonic pleural effusions/empyema (PPE/PE) are severe complications of community-acquired pneumonia. We investigated the bacterial aetiology and incidence of paediatric PPE/PE in Germany after the introduction of universal pneumococcal conjugate vaccine (PCV) immunization for infants. METHODS:Children <18 years of age hospitalized with pneumonia-associated PPE/PE necessitating pleural drainage or persisting >7 days were reported to the German Surveillance Unit for Rare Diseases in Childhood between October 2010 and June 2017. All bacteria detected in blood or pleural fluid (by culture/PCR) were included, with serotyping for Streptococcus pneumoniae. RESULTS: The median age of all 1447 PPE/PEpatients was 5 years (interquartile range 3-10). In 488 of the 1447 children with PPE/PE (34%), 541 bacteria (>40 species) were detected. Aerobic gram-positive cocci accounted for 469 of 541 bacteria detected (87%); these were most frequently Streptococcus pneumoniae (41%), Streptococcus pyogenes (19%) and Staphylococcus aureus (6%). Serotype 3 accounted for 45% of 78 serotyped S. pneumoniae strains. Annual PPE/PE incidence varied between 14 (95%CI 12-16) and 18 (95%CI 16-21) PPE/PE per million children. Incidence of S. pneumoniae PPE/PE decreased from 3.5 (95%CI 2.5-4.6) per million children in 2010/11 to 1.5 (95%CI 0.9-2.4) in 2013/14 (p 0.002), followed by a re-increase to 2.2 (95%CI 1.5-3.2) by 2016/17 (p 0.205). CONCLUSIONS: In the era of widespread PCV immunization, cases of paediatric PPE/PE were still caused mainly by S. pneumoniae and, increasingly, by S. pyogenes. The re-increase in the incidence of PPE/PE overall and in S. pneumoniae-associated PPE/PE indicates ongoing changes in the bacterial aetiology and requires further surveillance.
Authors: Johannes Forster; Britta Kohlmorgen; Julian Haas; Philipp Weis; Lukas Breunig; Doris Turnwald; Boris Mizaikoff; Christoph Schoen Journal: PLoS One Date: 2022-04-28 Impact factor: 3.752
Authors: Teresa Del Rosal; María Belén Caminoa; Alba González-Guerrero; Iker Falces-Romero; María Pilar Romero-Gómez; Fernando Baquero-Artigao; Talía Sainz; Ana Méndez-Echevarría; Luis Escosa-García; Francisco Javier Aracil; Cristina Calvo Journal: Front Pediatr Date: 2020-12-15 Impact factor: 3.418
Authors: L Golden; S Chaya; K Reichmuth; A Visagie; A Ayuk; S Kwarteng Owusu; D Marangu; N Affendi; A Lakhan; D Gray; A Vanker; H Zar; M Zampoli Journal: Afr J Thorac Crit Care Med Date: 2021-12-31