Assessing the impact of the 13 valent pneumococcal vaccine on childhood empyema in Australia.

Adolescent Australia / epidemiology Child Child, Preschool Empyema / epidemiology Female Hospitalization / statistics & numerical data Humans Incidence Infant Male Pneumococcal Infections / epidemiology Pneumococcal Vaccines Pneumonia, Bacterial / epidemiology
bacterial infection empyema respiratory infection

Journal

Thorax
ISSN: 1468-3296
Titre abrégé: Thorax
Pays: England
ID NLM: 0417353

Informations de publication

Date de publication:
05 2021
Historique:
received: 18 08 2020
revised: 04 11 2020
accepted: 04 12 2020
pubmed: 29 1 2021
medline: 13 7 2021
entrez: 28 1 2021
Statut: ppublish

Résumé

Empyema is a serious complication of pneumonia frequently caused by For bacterial pneumonia and empyema hospitalisations, we ascertained incidence rates (IRs) using the National Hospital Morbidity Database International Statistical Classification of Disease discharge codes and relevant population denominators, and calculated incidence rate ratios (IRR) comparing the 13vPCV period (June 2012-May 2017) with the 7vPCV period (June 2007-May 2011). Blood and pleural fluid (PF) cultures and PF PCR of 401 children with empyema from 11 Australian hospitals during the 13vPCV period were compared with our previous study in the 7vPCV period. Across 7vPCV and 13vPCV periods, IRs per million children (95% CIs) were 1605 (1588 to 1621) and 1272 (1259 to 1285) for bacterial pneumonia, and 14.23 (12.67 to 15.79) and 17.89 (16.37 to 19.42) for empyema hospitalisations. IRRs were 0.79 (0.78 to 0.80) for bacterial pneumonia and 1.25 (1.09 to 1.44) for empyema. Of 161 empyema cases with SP serotypes, 147 (91.3%) were vaccine types. ST3 accounted for 76.4% of identified serotypes in the 13vPCV period, more than double than the 7vPCV period (p<0.001); ST19A decreased from 36.4% to 12.4%. No cases of ST1 empyema were identified in the 13vPCV period versus 14.5% in the 7vPCV period. 13vPCV resulted in a significant reduction in all-cause hospitalisations for bacterial pneumonia but empyema hospitalisations significantly increased, with emergence of pneumococcal ST3 as the dominant serotype in empyema. Australian and New Zealand Clinical Trial Registry ACTRN 12614000354684.

Sections du résumé

BACKGROUND
Empyema is a serious complication of pneumonia frequently caused by
METHODS
For bacterial pneumonia and empyema hospitalisations, we ascertained incidence rates (IRs) using the National Hospital Morbidity Database International Statistical Classification of Disease discharge codes and relevant population denominators, and calculated incidence rate ratios (IRR) comparing the 13vPCV period (June 2012-May 2017) with the 7vPCV period (June 2007-May 2011). Blood and pleural fluid (PF) cultures and PF PCR of 401 children with empyema from 11 Australian hospitals during the 13vPCV period were compared with our previous study in the 7vPCV period.
FINDINGS
Across 7vPCV and 13vPCV periods, IRs per million children (95% CIs) were 1605 (1588 to 1621) and 1272 (1259 to 1285) for bacterial pneumonia, and 14.23 (12.67 to 15.79) and 17.89 (16.37 to 19.42) for empyema hospitalisations. IRRs were 0.79 (0.78 to 0.80) for bacterial pneumonia and 1.25 (1.09 to 1.44) for empyema. Of 161 empyema cases with SP serotypes, 147 (91.3%) were vaccine types. ST3 accounted for 76.4% of identified serotypes in the 13vPCV period, more than double than the 7vPCV period (p<0.001); ST19A decreased from 36.4% to 12.4%. No cases of ST1 empyema were identified in the 13vPCV period versus 14.5% in the 7vPCV period.
INTERPRETATION
13vPCV resulted in a significant reduction in all-cause hospitalisations for bacterial pneumonia but empyema hospitalisations significantly increased, with emergence of pneumococcal ST3 as the dominant serotype in empyema.
TRIAL REGISTRATION NUMBER
Australian and New Zealand Clinical Trial Registry ACTRN 12614000354684.

Identifiants

DOI: 10.1136/thoraxjnl-2020-216032 PMID: 33504566
pubmed: 33504566
pii: thoraxjnl-2020-216032
doi: 10.1136/thoraxjnl-2020-216032
doi:

Substances chimiques

13-valent pneumococcal vaccine 0
Pneumococcal Vaccines 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

487-493

Commentaires et corrections

Type : CommentIn

Informations de copyright

© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: HM is an investigator on sponsored vaccine trials. Her institution receives funding from Pfizer and GSK for investigator-led research. She does not receive any personal payments from Industry.

Auteurs

Roxanne Strachan (R)

Department of Respiratory Medicine, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia roxanne.strachan@health.nsw.gov.au.
ORCID: 0000-0002-2310-457X

Nusrat Homaira (N)

Department of Respiratory Medicine, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia.
School of Women's and Children's Health, University of New South Wales-Kensington Campus, Sydney, New South Wales, Australia.

Sean Beggs (S)

Department of Paediatrics, Royal Hobart Hospital, Hobart, Tasmania, Australia.
School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.

Mejbah U Bhuiyan (MU)

Division of Paediatrics, School of Medicine, Faculty of Health and Medical Science, University of Western Australia, Crawley, Western Australia, Australia.
Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia.
ORCID: 0000-0002-8274-6265

Gwendolyn L Gilbert (GL)

Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia.

Stephen B Lambert (SB)

School of Medicine, University of Queensland, UQ Child Health Research Centre, Brisbane, Queensland, Australia.
Children's Health Queensland, Queensland Paediatric Infectious Diseases Laboratory, Brisbane, Queensland, Australia.

Kristine Macartney (K)

Infectious Diseases, Children's Hospital at Westmead, Westmead, New South Wales, Australia.
National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Westmead, New South Wales, Australia.

Helen Marshall (H)

Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, Women's and Children's Health Network, North Adelaide, South Australia, Australia.
Child and Adolescent Health, Robinson Research Institute, The University of Adelaide, North Adelaide, South Australia, Australia.

Andrew C Martin (AC)

Paediatrics, Princess Margaret Hospital For Children, Perth, Western Australia, Australia.

Gabrielle B McCallum (GB)

Child Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia.

Angela McCullagh (A)

Respiratory and Sleep Medicine, Monash Children's Hospital, Melbourne, Victoria, Australia.
Paediatrics, Monash University, Clayton, Victoria, Australia.
ORCID: 0000-0003-2172-692X

Tim McDonald (T)

Paediatrics, Canberra Hospital, Canberra, Australian Capital Territory, Australia.

Peter McIntyre (P)

Infectious Diseases, Children's Hospital at Westmead, Westmead, New South Wales, Australia.
Women's and Children's Health, University of Otago-Dunedin Campus, Dunedin, New Zealand.

Shahin Oftadeh (S)

Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Wentworthville, New South Wales, Australia.

Sarath Ranganathan (S)

Paediatrics, The University of Melbourne Department of Paediatrics, Parkville, Victoria, Australia.
Infection and Immunology, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.

Sadasivam Suresh (S)

Department of Respiratory Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia.

Claire E Wainwright (CE)

Respiratory and Sleep Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia.
Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.

Angela Wilson (A)

Department of Paediatrics, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.

Melanie Wong (M)

Immunology, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.

Thomas Snelling (T)

School of Women's and Children's Health, The University of Sydney, Sydney, New South Wales, Australia.

Adam Jaffé (A)

Department of Respiratory Medicine, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia.
School of Women's and Children's Health, University of New South Wales-Kensington Campus, Sydney, New South Wales, Australia.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Assessing the impact of the 13 valent...
questionsmedicales.fr › Régions géographiques › Océanie › Australasie › Australie › Assessing the impact of the 13 valent...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Assessing the impact of the 13 valent...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Enfant d'âge préscolaire › Assessing the impact of the 13 valent...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Inflammation › Suppuration › Empyème › Assessing the impact of the 13 valent...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Hospitalisation › Assessing the impact of the 13 valent...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Assessing the impact of the 13 valent...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Morbidité › Incidence › Assessing the impact of the 13 valent...
questionsmedicales.fr › Personnes › Tranches d'âge › Nourrisson › Assessing the impact of the 13 valent...
questionsmedicales.fr › Infection › Infections bactériennes et mycoses › Infections bactériennes › Infections bactériennes à Gram positif › Infections à streptocoques › Infections à pneumocoques › Assessing the impact of the 13 valent...
questionsmedicales.fr › Mélanges complexes › Produits biologiques › Vaccins › Vaccins antibactériens › Vaccins antistreptococciques › Vaccins antipneumococciques › Assessing the impact of the 13 valent...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie bactérienne › Assessing the impact of the 13 valent...