Empyema hospitalizations increased in US children despite pneumococcal conjugate vaccine

Area of Science:

• Pediatric infectious diseases
• Public health surveillance
• Vaccine impact studies

Background:

• Empyema, a serious lung infection, poses a significant health burden in children.
• The introduction of the pneumococcal conjugate vaccine (PCV) in 2000 aimed to reduce pneumococcal disease incidence.
• Understanding trends in empyema is crucial for assessing vaccine effectiveness and public health strategies.

Purpose of the Study:

• To investigate changes in the incidence of childhood empyema hospitalizations in the United States following PCV introduction.
• To compare empyema hospitalization rates before and after the widespread use of PCV.

Main Methods:

• Utilized the Kids' Inpatient Database, a national pediatric hospitalization dataset.
• Estimated annual empyema-associated hospitalizations for children aged 0-18 years in 1997, 2000, 2003, and 2006.
• Calculated incidence rates per 100,000 children using US Census data and compared rates across study years.

Main Results:

• Empyema-associated hospitalizations increased by nearly 70% between 1997 (2.2 per 100,000) and 2006 (3.7 per 100,000).
• Rates of complicated pneumonia also rose by 44% during the study period.
• Concurrently, rates of bacterial pneumonia decreased by 13%, and invasive pneumococcal disease by 50%.

Conclusions:

• Childhood empyema hospitalization rates significantly increased between 1997 and 2006.
• These findings suggest that the pneumococcal conjugate vaccine has not effectively reduced the incidence of childhood empyema.
• Further research is needed to understand the factors contributing to the rising empyema rates despite PCV use.