title: Bacterial causes of empyema in children, Australia, 2007-2009.
abstract: An increase in the incidence of empyema worldwide could be related to invasive pneumococcal disease caused by emergent nonvaccine replacement serotypes. To determine bacterial pathogens and pneumococcal serotypes that cause empyema in children in Australia, we conducted a 2-year study of 174 children with empyema. Blood and pleural fluid samples were cultured, and pleural fluid was tested by PCR. Thirty-two (21.0%) of 152 blood and 53 (33.1%) of 160 pleural fluid cultures were positive for bacteria; Streptococcus pneumoniae was the most common organism identified. PCR identified S. pneumoniae in 74 (51.7%) and other bacteria in 19 (13.1%) of 145 pleural fluid specimens. Of 53 samples in which S. pneumoniae serotypes were identified, 2 (3.8%) had vaccine-related and 51 (96.2%) had nonvaccine serotypes; 19A (n = 20; 36.4%), 3 (n = 18; 32.7%), and 1 (n = 8; 14.5%) were the most common. High proportions of nonvaccine serotypes suggest the need to broaden vaccine coverage.
authors: Sydney Children's Hospital, Randwick, New South Wales, Australia.
authors: Roxanne E
authors: RE
authors: Strachan
authors: Anita
authors: A
authors: Cornelius
authors: Gwendolyn L
authors: GL
authors: Gilbert
authors: Tanya
authors: T
authors: Gulliver
authors: Andrew
authors: A
authors: Martin
authors: Tim
authors: T
authors: McDonald
authors: Gillian M
authors: GM
authors: Nixon
authors: Rob
authors: R
authors: Roseby
authors: Sarath
authors: S
authors: Ranganathan
authors: Hiran
authors: H
authors: Selvadurai
authors: Greg
authors: G
authors: Smith
authors: Manuel
authors: M
authors: Soto-Martinez
authors: Sadasivam
authors: S
authors: Suresh
authors: Laurel
authors: L
authors: Teoh
authors: Kiran
authors: K
authors: Thapa
authors: Claire E
authors: CE
authors: Wainwright
authors: Adam
authors: A
authors: Jaffe
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D004653:Empyema / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009238:N-Acetylmuramoyl-L-alanine Amidase / Q000235:genetics; D010996:Pleural Effusion / Q000382:microbiology; D022242:Pneumococcal Vaccines; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; D022242:Pneumococcal Vaccines; D009238:N-Acetylmuramoyl-L-alanine Amidase