Related Experiment Video
Updated: Mar 12, 2026
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Changes in empyema among U.S. children in the pneumococcal conjugate vaccine era
Andrew D Wiese1, Marie R Griffin2, Yuwei Zhu3
1Department of Health Policy, Vanderbilt University, Nashville, USA.
Insights
Childhood empyema hospitalizations increased after the 7-valent pneumococcal conjugate vaccine (PCV7) but declined following the 13-valent pneumococcal conjugate vaccine (PCV13) introduction. PCV13 significantly reduced empyema rates in children under two years old.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Public health surveillance
Background:
- Parapneumonic empyema incidence in US children rose before and after PCV7 introduction.
- This rise was partly due to serotypes later included in PCV13.
Purpose of the Study:
- To assess changes in childhood empyema hospitalization rates after PCV13 introduction.
- To analyze trends in empyema etiology following PCV13 implementation.
Main Methods:
- Analysis of Nationwide Inpatient Sample and Census data (1997-2013).
- Calculation of annualized empyema hospitalization rates for US children <18 years.
- Comparison of rates across pre-PCV7, early-PCV7, late-PCV7, and post-PCV13 periods.
Main Results:
- Empyema hospitalization rates peaked at 3.6 per 100,000 in the late-PCV7 period.
- Post-PCV13 rates declined to 2.0 per 100,000, similar to pre-PCV7 levels.
- Rates decreased significantly in children <2 years post-PCV13; pneumococcal and unspecified empyema declined.
Conclusions:
- Empyema hospitalizations in children peaked after PCV7 introduction.
- PCV13 introduction led to a substantial decrease in childhood empyema hospitalizations.
Background:
Parapneumonic empyema, a serious complication of pneumonia, started increasing among U.S. children before the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in 2000, and continued afterwards. This increase was due in part to pneumococcal serotypes not included in PCV7 that were included in the new 13-valent (PCV13) vaccine introduced in 2010. We assessed changes in the incidence of empyema hospitalizations among U.S. children after PCV13 introduction.
Methods:
We calculated annualized empyema hospitalization rates among U.S. children <18years using Nationwide Inpatient Sample and Census data (1997-2013) for four periods based on PCV7 and PCV13 introductions. Relative rates (RR) and 95% confidence intervals (CI) were calculated by age group and sex, comparing PCV7 [early-PCV7 (2001-2005) and late-PCV7 (2006-2009)] and PCV13 (2011-2013) periods with the pre-PCV7 period (1997-1999). Secondary analyses examined changes in pneumococcal, streptococcal, staphylococcal and unspecified empyema.
Results:
Among children <18years of age, annualized empyema hospitalization rates peaked at 3.6 per 100,000 in the late-PCV7 period compared with 2.1 per 100,000 in the pre-PCV7 period [RR: 1.70 (95% CI: 1.11-2.60)]. However, annualized rates in the post-PCV13 period declined to 2.0 per 100,000, similar to rates in the pre-PCV7 period. Empyema rates among children <2years were lower in the post-PCV13 period compared to the pre-PCV7 period [RR: 0.77 (95% CI: 0.61-0.96)], but rates in the two periods among children 2-4 and 5-17years were similar. Most empyema were of unspecified etiology. Pneumococcal and unspecified empyema declined after PCV13 introduction.
Conclusions:
Although empyema hospitalization rates among U.S. children peaked after PCV7 introduction, rates decreased substantially following the introduction of PCV13.
More Related Videos
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:30Pneumonia III: Complications and Assessment
01:51Vaccinations
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:29Pneumonia II: Pathophysiology