Bacterial Causes of Empyema in Children, Australia, 2007–2009

• Main Authors: Roxanne E. Strachan, Anita Cornelius, Gwendolyn L. Gilbert, Tanya Gulliver, Andrew Martin, Tim McDonald, Gillian M. Nixon, Rob Roseby, Sarath Ranganathan, Hiran Selvadurai, Greg Smith, Manuel Soto-Martinez, Sadasivam Suresh, Laurel Teoh, Kiran Thapa, Claire E. Wainwright, Adam Jaffé
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2011-10-01
• Series: Emerging Infectious Diseases
• Subjects: Streptococcus pneumoniae; empyema; child; bacteria; polymerase chain reaction; Australia
• Online Access: https://wwwnc.cdc.gov/eid/article/17/10/10-1825_article

An increase in the incidence of empyema worldwide could be related to invasive pneumococcal disease caused by emergent nonvaccine replacement serotypes. To determine bacterial pathogens and pneumococcal serotypes that cause empyema in children in Australia, we conducted a 2-year study of 174 children with empyema. Blood and pleural fluid samples were cultured, and pleural fluid was tested by PCR. Thirty-two (21.0%) of 152 blood and 53 (33.1%) of 160 pleural fluid cultures were positive for bacteria; Streptococcus pneumoniae was the most common organism identified. PCR identified S. pneumoniae in 74 (51.7%) and other bacteria in 19 (13.1%) of 145 pleural fluid specimens. Of 53 samples in which S. pneumoniae serotypes were identified, 2 (3.8%) had vaccine-related and 51 (96.2%) had nonvaccine serotypes; 19A (n = 20; 36.4%), 3 (n = 18; 32.7%), and 1 (n = 8; 14.5%) were the most common. High proportions of nonvaccine serotypes suggest the need to broaden vaccine coverage.