Literature DB >> 33504566

Assessing the impact of the 13 valent pneumococcal vaccine on childhood empyema in Australia.

Roxanne Strachan1, Nusrat Homaira2,3, Sean Beggs4,5, Mejbah U Bhuiyan6,7, Gwendolyn L Gilbert8, Stephen B Lambert9,10, Kristine Macartney11,12, Helen Marshall13,14, Andrew C Martin15, Gabrielle B McCallum16, Angela McCullagh17,18, Tim McDonald19, Peter McIntyre11,20, Shahin Oftadeh21, Sarath Ranganathan22,23, Sadasivam Suresh24, Claire E Wainwright25,26, Angela Wilson27, Melanie Wong28, Thomas Snelling29, Adam Jaffé2,3.   

Abstract

BACKGROUND: Empyema is a serious complication of pneumonia frequently caused by Streptococcus pneumoniae (SP). We assessed the impact of the 13-valent pneumococcal conjugate vaccine (13vPCV) on childhood pneumonia and empyema after inclusion in the Australian National Immunisation Program.
METHODS: For bacterial pneumonia and empyema hospitalisations, we ascertained incidence rates (IRs) using the National Hospital Morbidity Database International Statistical Classification of Disease discharge codes and relevant population denominators, and calculated incidence rate ratios (IRR) comparing the 13vPCV period (June 2012-May 2017) with the 7vPCV period (June 2007-May 2011). Blood and pleural fluid (PF) cultures and PF PCR of 401 children with empyema from 11 Australian hospitals during the 13vPCV period were compared with our previous study in the 7vPCV period.
FINDINGS: Across 7vPCV and 13vPCV periods, IRs per million children (95% CIs) were 1605 (1588 to 1621) and 1272 (1259 to 1285) for bacterial pneumonia, and 14.23 (12.67 to 15.79) and 17.89 (16.37 to 19.42) for empyema hospitalisations. IRRs were 0.79 (0.78 to 0.80) for bacterial pneumonia and 1.25 (1.09 to 1.44) for empyema. Of 161 empyema cases with SP serotypes, 147 (91.3%) were vaccine types. ST3 accounted for 76.4% of identified serotypes in the 13vPCV period, more than double than the 7vPCV period (p<0.001); ST19A decreased from 36.4% to 12.4%. No cases of ST1 empyema were identified in the 13vPCV period versus 14.5% in the 7vPCV period.
INTERPRETATION: 13vPCV resulted in a significant reduction in all-cause hospitalisations for bacterial pneumonia but empyema hospitalisations significantly increased, with emergence of pneumococcal ST3 as the dominant serotype in empyema. TRIAL REGISTRATION NUMBER: Australian and New Zealand Clinical Trial Registry ACTRN 12614000354684. © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Entities:  

Keywords:  bacterial infection; empyema; respiratory infection

Year:  2021        PMID: 33504566     DOI: 10.1136/thoraxjnl-2020-216032

Source DB:  PubMed          Journal:  Thorax        ISSN: 0040-6376            Impact factor:   9.139


  4 in total

1.  Management of thoracic empyema in children: a survey of the Australia and New Zealand Association of Paediatric Surgeons (ANZAPS).

Authors:  Damir Ljuhar; Jessica Rayner; Ela Hyland; Sebastian King
Journal:  Pediatr Surg Int       Date:  2021-03-22       Impact factor: 1.827

2.  Characteristics, management and changing incidence of children with empyema in a paediatric intensive care unit.

Authors:  Rami Subhi; Ben Gelbart; Natasha Ching; Jenny Thompson; Joshua Osowicki; Thomas H Rozen; Shivanthan Shanthikumar; Warwick Teague; Trevor Duke
Journal:  J Paediatr Child Health       Date:  2022-02-22       Impact factor: 1.929

3.  Continued Vaccine Breakthrough Cases of Serotype 3 Complicated Pneumonia in Vaccinated Children, Portugal (2016-2019).

Authors:  Catarina Silva-Costa; Joana Gomes-Silva; Marcos D Pinho; Ana Friães; Mário Ramirez; José Melo-Cristino
Journal:  Microbiol Spectr       Date:  2022-07-06

4.  Pneumococcal Disease Prevention: Are We on the Right Track?

Authors:  Nicola Principi; Susanna Esposito
Journal:  Vaccines (Basel)       Date:  2021-03-24
  4 in total

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