title: Sustained high prevalence of pneumococcal serotype 1 in paediatric parapneumonic empyema in southern Spain from 2005 to 2009.
abstract: The epidemiology and microbiological characteristics of paediatric parapneumonic empyema (PPE) before the introduction of the new generation of conjugate pneumococcal vaccines (10-valent and 13-valent) are described. All patients <14 years old admitted to a tertiary paediatric hospital with a diagnosis of PPE were prospectively enrolled from January 2005 to December 2009. Pneumococcal serotyping of culture-negative pleural fluid samples was performed using a multiplex real-time PCR assay. Overall, 219 patients had PPE. Incidence rates for PPE remained stable during the study period with a not significant increase in 2009 compared with 2005 (p 0.13), and were temporally associated with higher circulation of pandemic influenza A H1N1 during the last quarter in our population (p 0.001). Pneumococci were detected in 72% of culture-positive and 79% of culture-negative samples. Serotypes were determined in 104 PPE cases. Serotype 1 was the most prevalent serotype identified (42%) followed by serotypes 7F (20%), 3 (16%), 19A (8%) and 5 (7%). Serotype distribution remained similar during all time periods. Pneumococcal serotype 1 remained the most common cause of PPE during the 5-year study. The new generation of pneumococcal conjugate vaccines offers potential serotype coverage of 73% (10-valent) and 99% (13-valent) in the population studied suffering from PPE. Continuous epidemiological and molecular studies are paramount to monitor the impact of pneumococcal vaccines on the epidemiology of PPE.
authors.affiliation: Department of Paediatric Infectious Diseases and Immunology, Hospital Infantil Universitario Virgen del Rocío, Sevilla, Spain. IOSANTAELLA@telefonica.net
authors.forename: I
authors.initials: I
authors.lastname: Obando
authors.forename: M S
authors.initials: MS
authors.lastname: Camacho-Lovillo
authors.forename: A
authors.initials: A
authors.lastname: Porras
authors.forename: M A
authors.initials: MA
authors.lastname: Gandía-González
authors.forename: A
authors.initials: A
authors.lastname: Molinos
authors.forename: I
authors.initials: I
authors.lastname: Vazquez-Barba
authors.forename: B
authors.initials: B
authors.lastname: Morillo-Gutierrez
authors.forename: O W
authors.initials: OW
authors.lastname: Neth
authors.forename: D
authors.initials: D
authors.lastname: Tarrago
mesh_terms: D002648:Child; D002675:Child, Preschool; D004653:Empyema / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D058889:Molecular Typing; D060885:Multiplex Polymerase Chain Reaction; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D022242:Pneumococcal Vaccines / Q000276:immunology; D015995:Prevalence; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction; D012703:Serotyping; D013030:Spain / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D022242:Pneumococcal Vaccines