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Serotypes associated with the development of pneumococcal para-pneumonic effusion in adults

Thomas Bewick1, Carmen Sheppard, Sonia Greenwood

  • 1Dept of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.

The European Respiratory Journal
|December 22, 2012
PubMed

Insights

Certain pneumococcal serotypes (1, 3, 7F, 19A) commonly linked to childhood pneumonia complications are also significantly associated with adult para-pneumonic effusion (PPE). This finding highlights potential shifts in disease spectrum due to pneumococcal vaccination programs.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Vaccinology

Background:

  • Childhood para-pneumonic effusion (PPE) is often caused by specific Streptococcus pneumoniae serotypes (1, 3, 7F, 19A).
  • The association between pneumococcal serotypes and adult PPE remains less understood.
  • Community-acquired pneumonia (CAP) is a significant cause of morbidity and mortality in adults.

Purpose of the Study:

  • To investigate the specific pneumococcal serotypes associated with adult PPE.
  • To compare serotype prevalence in adult PPE with that observed in childhood PPE.
  • To assess the impact of pneumococcal conjugate vaccines (PCVs) on serotype distribution in adult PPE.

Main Methods:

  • Prospective cohort study over 2 years.
  • Inclusion of consecutive adult patients admitted with CAP.
  • Pneumococcal serotyping from urine samples using multiplex immunoassay.

Main Results:

  • Of 920 CAP patients, 100 had PPE; serotype determined in 73.
  • Serotypes 1, 19A, and 3 were most frequently associated with adult PPE.
  • Serotypes common in childhood PPE were independently associated with adult PPE (aOR 2.3).
  • Non-PCV7 serotypes were more likely associated with PPE (OR 2.1).

Conclusions:

  • Serotypes 1, 3, 7F, and 19A are independently associated with adult PPE, mirroring findings in childhood PPE.
  • Serotype replacement following pneumococcal vaccine implementation may alter the clinical presentation of PPE.
  • These findings have implications for vaccine strategies and clinical management of adult pneumonia.

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