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Pediatric parapneumonic effusion before and after national pneumococcal vaccination programs in Taiwan
Jun Yi Sim1, Luan-Yin Chang2, Tu-Hsuan Chang3
1Department of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289 Jianguo Road, Xindian District, New Taipei City, 23142, Taiwan.
Insights
Pneumococcal conjugate vaccines (PCVs) significantly reduced pneumococcal empyema in children. Continuous surveillance is crucial for monitoring other pathogens like Mycoplasma pneumoniae.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Respiratory Medicine
Background:
- Limited data exists on the impact of pneumococcal conjugate vaccines (PCVs) on pediatric parapneumonic effusion.
- This study investigates changes in pediatric parapneumonic effusion cases and causes before and after PCV13 introduction.
Purpose of the Study:
- To evaluate the effectiveness of national PCV13 vaccination programs on pediatric parapneumonic effusion.
- To identify changes in the etiology of pediatric parapneumonic effusion post-PCV13 implementation.
Main Methods:
- Retrospective analysis of medical records of children (0-18 years) admitted with lobar pneumonia and parapneumonic effusion (2008-2017).
- Inclusion of patients with effusion analyses, examining blood, pleural fluid, and respiratory specimens.
- Comparison of data before and after the national PCV13 vaccination program in Taiwan.
Main Results:
- A pathogen was identified in 85% of 202 children with lobar pneumonia and parapneumonic effusion.
- Pneumococcal empyema decreased by 72% in 2- to 5-year-olds post-PCV13 immunization.
- Mycoplasma pneumoniae emerged as the second most common cause, with distinct clinical characteristics compared to pneumococcal infections.
Conclusions:
- National PCV13 immunization programs demonstrated significant effectiveness against pneumococcal empyema in children, sustained over 4 years.
- Ongoing surveillance is essential to track the emergence of non-PCV serotypes and other pathogens like M. pneumoniae.
Background:
Reports on the effectiveness of pneumococcal conjugate vaccines (PCVs) on pediatric parapneumonic effusion are limited. We report the changes in cases and etiologies of pediatric parapneumonic effusion in a children's hospital before and after national PCV13 vaccination programs.
Methods:
We screened medical records of children 0-18 years admitted to the National Taiwan University Hospital with diagnoses of lobar pneumonia and parapneumonic effusion between 2008 and 2017. Patients with effusion analyses were included. Results of blood, pleural fluid, and respiratory specimens surveyed as standard care were analyzed.
Results:
Diagnostic testing revealed at least a pathogen in 85% of 202 children with lobar pneumonia and parapneumonic effusion. After national PCV13 immunization, pneumococcal empyema decreased by 72% among 2- to 5-year olds. Mycoplasma pneumoniae was the second most common etiology. There were marked differences in effusion characteristics, metabolic, and respiratory parameters between children infected with pneumococcus and M. pneumoniae.
Conclusion:
The effectiveness of the national PCV13 immunization programs on pneumococcal empyema was evident and remained substantial after 4 years in Taiwan. Continuous surveillance is important to monitor the emergence of other pathogens including non-PCV serotypes and M. pneumoniae.
