Characteristics of Streptococcus pyogenes Versus Streptococcus pneumoniae Pleural Empyema and Pneumonia With Pleural

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Orli Megged1

  • 1From the Pediatric department and Infectious Diseases Unit, Shaare Zedek Medical Center affiliated with Hebrew University-Hadassah School of Medicine, Jerusalem, Israel.

The Pediatric Infectious Disease Journal
|August 18, 2020
PubMed

Insights

While Streptococcus pneumoniae (SP) is decreasing, Streptococcus pyogenes (GAS) is an increasing cause of pediatric empyema, leading to longer hospital stays and more severe illness.

Area of Science:

  • Pediatric Infectious Diseases
  • Respiratory Medicine
  • Microbiology

Background:

  • Streptococcus pneumoniae (SP) is a declining cause of pediatric complicated pneumonia due to vaccination.
  • Streptococcus pyogenes (GAS) is an emerging pathogen in pediatric community-acquired pleuropneumonia/empyema.
  • The relative incidence of GAS as a cause of pediatric empyema is increasing.

Purpose of the Study:

  • To compare the clinical and laboratory characteristics of pediatric pleuropneumonia/empyema caused by GAS versus SP.
  • To analyze trends in the incidence of GAS and SP empyema in children over a 15-year period.

Main Methods:

  • Retrospective review of medical records for children aged 0-18 years (2004-2019).
  • Inclusion criteria: discharge diagnosis of pleuropneumonia or empyema with positive blood and/or pleural fluid culture for GAS or SP.
  • Comparison of clinical and laboratory features between GAS and SP groups.

Main Results:

  • Ninety cases were analyzed: 20 GAS and 70 SP.
  • Children with GAS empyema had larger pleural effusions requiring drainage and longer hospitalizations compared to SP.
  • GAS empyema cases were less likely to have positive blood cultures but more frequently identified in pleural fluid.

Conclusions:

  • GAS empyema is associated with greater morbidity and prolonged hospitalization in children compared to SP empyema.
  • GAS is often isolated from pleural fluid, highlighting the importance of pleural fluid analysis for diagnosis.
  • The rising incidence of GAS empyema warrants continued surveillance and awareness.
Abstract

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