Molecular epidemiology of pediatric pneumococcal empyema from 2001 to 2007 in Utah.
Utah had a high rate of pediatric pneumococcal empyema (PPE) prior to licensure of the pneumococcal conjugate vaccine (PCV-7) in 2000. The majority (62%) of PPE cases was due to nonvaccine serotypes, primarily Streptococcus pneumoniae serotype 1, multilocus sequence type (MLST) 227. PPE in Utah children has increased over the last decade. It is unclear whether the increase was due to serotype replacement or switch. In this study, we describe the incidence and molecular epidemiology of PPE by MLST in Utah children after the licensure of PCV-7. Empyema rates increased from 8.5/100,000 children in the state of Utah in 2001 to 12.5/100,000 children in 2007 (P = 0.006). Ninety-eight percent was due to nonvaccine serotypes (P < 0.001 when compared to the pre-PCV-7 period). PPE was primarily due to serotypes 1, 3, 19A, and 7F, with MLST demonstrating sequence types (ST) that were commonly present in the United States prior to licensure of PCV-7. Serotype switch was not documented. Replacement disease with common ST of serotypes 1,3, 7F, and 19A rather than serotype switch was responsible for the increase in PPE in Utah children.
Byington
Carrie L
CL
Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84108, USA. Carrie.byington@hsc.utah.edu
Hulten
Kristina G
KG
Ampofo
Krow
K
Sheng
Xiaoming
X
Pavia
Andrew T
AT
Blaschke
Anne J
AJ
Pettigrew
Melinda
M
Korgenski
Kent
K
Daly
Judy
J
Mason
Edward O
EO
D015373:Bacterial Typing Techniques; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004653:Empyema / Q000453:epidemiology* / Q000382:microbiology*; D005838:Genotype; D006801:Humans; D015994:Incidence; D017720:Molecular Epidemiology; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D022242:Pneumococcal Vaccines / Q000276:immunology; D017422:Sequence Analysis, DNA; D017385:Sequence Homology; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D014589:Utah / Q000453:epidemiology
D004269:DNA, Bacterial; D022242:Pneumococcal Vaccines