Emergence of pneumococcal 19A empyema in UK children.
BACKGROUND
Invasive pneumococcal disease due to serotype 19A has become a major concern, particularly in the USA and Asia. We describe the characteristics of pneumococcal serotype 19A related empyema and changes in its incidence in the UK.


METHODS
Data from paediatric empyema patients between September 2006 and March 2011 were collected from 17 respiratory centres in the UK. Pneumococcal serotypes were identified as part of the Health Protection Agency enhanced paediatric empyema surveillance programme.


RESULTS
Four serotypes accounted for over 80% of 136 cases (Serotype 1 : 43%, 3 : 21%, 7 : 11% and 19A:10%). The incidence of empyema due to serotype 19A quadrupled from 0.48 (0.16-1.13) cases per million children in 2006/2007 to 2.02 (1.25-3.09) in 2010/2011. Severity of disease was significantly increased in children with 19A infection when compared to other serotypes.


CONCLUSIONS
The incidence of empyema due to pneumococcal serotype 19A infection has increased significantly and is associated with substantial morbidity.
Department of Respiratory Paediatrics, Great North Children's Hospital, Newcastle-Upon-Tyne, Tyne & Wear, UK.
Matthew F
MF
Thomas
Carmen L
CL
Sheppard
Malcolm
M
Guiver
Mary P E
MP
Slack
Robert C
RC
George
Russell
R
Gorton
James Y
JY
Paton
Clare
C
Simmister
David
D
Cliff
Mohamed A
MA
Elemraid
Julia E
JE
Clark
Stephen P
SP
Rushton
David Anthony
DA
Spencer
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004653:Empyema / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011008:Pneumococcal Infections / Q000453:epidemiology*; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification*; D006113:United Kingdom / Q000453:epidemiology