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Published on: February 23, 2014

Bacterial causes of empyema in children, Australia, 2007-2009

Roxanne E Strachan1, Anita Cornelius, Gwendolyn L Gilbert

  • 1Sydney Children's Hospital, Randwick, New South Wales, Australia.

Emerging Infectious Diseases
|October 18, 2011
PubMed

Insights

Childhood empyema is increasingly linked to Streptococcus pneumoniae. A study found most cases involved nonvaccine serotypes, highlighting the need for broader vaccine protection against this bacterial lung infection.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Rising global incidence of empyema, particularly in children.
  • Potential link between empyema and invasive pneumococcal disease caused by nonvaccine Streptococcus pneumoniae serotypes.

Purpose of the Study:

  • To identify bacterial pathogens and specific Streptococcus pneumoniae serotypes causing empyema in Australian children.
  • To assess the role of vaccine-preventable and nonvaccine serotypes in childhood empyema.

Main Methods:

  • Prospective 2-year study involving 174 children diagnosed with empyema.
  • Collection and culture of blood and pleural fluid samples.
  • Polymerase chain reaction (PCR) testing of pleural fluid for bacterial identification and serotyping.

Main Results:

  • Streptococcus pneumoniae was the most frequently identified bacterium in both blood and pleural fluid cultures.
  • PCR confirmed Streptococcus pneumoniae in 51.7% and other bacteria in 13.1% of pleural fluid samples.
  • Of the identified Streptococcus pneumoniae serotypes, 96.2% were nonvaccine types, with serotypes 19A, 3, and 1 being most prevalent.

Conclusions:

  • The study underscores a significant predominance of nonvaccine Streptococcus pneumoniae serotypes in childhood empyema cases in Australia.
  • Findings suggest current pneumococcal vaccines may have limited coverage for the serotypes causing empyema.
  • Recommendations include the need to broaden pneumococcal vaccine serotype coverage to address the evolving epidemiology of childhood empyema.

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