title: The increasing incidence of empyema.
abstract: OBJECTIVE
  The aim of this review is to highlight recent changes concerning the incidence of empyema. In this article we have focused on community-acquired empyema
  
  
  RESULTS
  The incidence of empyema seems to have been increasing both in children and adults worldwide in the past decades, mainly in healthy young adults and in older patients. The bacteriology of pleural infection is changing as well. In children, the most common microorganism that causes empyema continues to be Streptococcus pneumoniae. Interestingly, the widespread use of the seven valent conjugate vaccine has produced a replacement phenomenon with the emergence of some pneumococcal serotypes such as serotypes 1, 3 and 19A, which have a higher propensity to cause empyema. Moreover increases in the incidence of empyema due to Staphylococcus aureus have also been observed. In adults, increases in the rate of empyema due to Streptococcus milleri group and S. aureus have been reported.
  
  
  CONCLUSIONS
  Continued surveillance in the epidemiology of empyema is needed. Progress in new strategies of prevention, such as a new generation of conjugate pneumococcal vaccines and protein-based vaccines, could become an important step in the control of this important complication.
authors.affiliation: Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Spain. jburgos@vhebron.net
authors.forename: Joaquín
authors.initials: J
authors.lastname: Burgos
authors.forename: Vicenç
authors.initials: V
authors.lastname: Falcó
authors.forename: Albert
authors.initials: A
authors.lastname: Pahissa
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002353:Carrier State / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000517:prevention & control; D004653:Empyema / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D018571:Sentinel Surveillance; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D014481:United States / Q000453:epidemiology
chemical_list: D022242:Pneumococcal Vaccines