Culture-Negative Childhood Empyema Is Usually Due to Penicillin-Sensitive
            <i>Streptococcus pneumoniae</i>
            Capsular Serotype 1

Eltringham, Gary; Kearns, Angela; Freeman, R.; Clark, Julia; Spencer, David A.; Eastham, Katherine; Harwood, Jayne; Leeming, J.P.

doi:10.1128/jcm.41.1.521-522.2003

Cited by 54 publications

(31 citation statements)

References 3 publications

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“…The difficulty of culture-confirmed diagnosis remains a problem in pediatric empyema (1,28). In our study, pleural fluid cultures were negative for all the patients, which may have been related to the use of antibiotics before admission to the study centers.…”

Section: Discussionmentioning

confidence: 80%

Distribution of Streptococcus pneumoniae Serotypes That Cause Parapneumonic Empyema in Turkey

Ceyhan

Özsürekçi

Gürler

et al. 2013

Clin. Vaccine Immunol.

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Streptococcus pneumoniae is the most common etiological cause of complicated pneumonia, including empyema. In this study, we investigated the serotypes of S. pneumoniae that cause empyema in children. One hundred fifty-six children who were diagnosed with pneumonia complicated with empyema in 13 hospitals in seven geographic regions of Turkey between 2010 and 2012 were included in this study. Pleural fluid samples were collected by thoracentesis and tested for 14 serotypes/serogroups using a Bio-Plex multiplex antigen detection assay. The serotypes of S. pneumoniae were specified in 33 of 156 samples. The mean age ؎ the standard deviation of the 33 patients was 6.17 ؎ 3.54 years (range, 0.6 to 15 years). All of the children were unvaccinated according to the vaccination reports. Eighteen of the children were male, and 15 were female. The serotypes of the non-7-valent pneumococcal conjugated vaccine (non-PCV-7), serotype 1, serotype 5, and serotype 3, were detected in eight (14.5%), seven (12.7%), and five (9.1%) of the samples, respectively. Serotypes 1 and 5 were codetected in two samples. The remaining non-PCV-7 serotypes were 8 (n ‫؍‬ 3), 18 (n ‫؍‬ 1), 19A (n ‫؍‬ 1), and 7F/A (n ‫؍‬ 1). PCV-7 serotypes 6B, 9V, 14, 19F, and 23F were detected in nine (16.3%) of the samples. The potential serotype coverages of PCV-7, PCV-10, and PCV-13 were 16.3%, 45.4%, and 60%, respectively. Pediatric parapneumonic empyema continues to be an important health problem despite the introduction of conjugated pneumococcal vaccines. Active surveillance studies are needed to monitor the change in S. pneumoniae serotypes that cause empyema in order to have a better selection of pneumococcal vaccines.

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Section: Discussionmentioning

confidence: 80%

Distribution of Streptococcus pneumoniae Serotypes That Cause Parapneumonic Empyema in Turkey

Ceyhan

Özsürekçi

Gürler

et al. 2013

Clin. Vaccine Immunol.

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“…Children with non-PCV7 infections had hospital stays nearly twice as long as children with IPD due to the PCV7 serogroups, in part because of the high rate of empyema. Other regions of the United States and the United Kingdom are reporting increases among children in the incidence of complicated pneumonia related to serotype 1 disease, specifically pneumonia caused by sequence type 227 [33,[43][44][45][46][47][48]. We believe that surveillance for serotype 1 disease and strategies to prevent its further emergence in the United States will become increasingly important.…”

Section: Discussionmentioning

confidence: 93%

Temporal Trends of Invasive Disease Due to Streptococcus pneumoniae among Children in the Intermountain West: Emergence of Nonvaccine Serogroups

Byington¹,

Samore

Stoddard

et al. 2005

Clinical Infectious Diseases

215

137

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The incidence of IPD in the IMW decreased by 27% after the introduction of the PCV7 vaccine. During the postvaccine period (2001-2003), there were significant decreases in the proportion of cases of IPD caused by PCV7 and antibiotic-resistant serogroups. These benefits were accompanied by a significant increase in the proportion of IPD cases due to non-PCV7 serogroups, with increases in the incidence of empyema and severe IPD.

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“…Interestingly, serotype 1 disease has been reported to be decreasing in North America (21) (ranked 17th, per reference 11) and Egypt (69). Serotype 1 is associated with complicated pneumonia, pulmonary empyema, peritonitis, and salpingitis (19,49,65,66,72) and has been directly linked to mortality, irrespective of factors such as age, environment, and leukocyte count of patients (47). Along with serotypes 5 and 7, serotype 1 is also associated with a higher ratio of hospitalization versus ambulatory care compared with pneumococcal infections from other serotypes (2).…”

mentioning

confidence: 99%

Identification of Invasive Serotype 1 Pneumococcal Isolates That Express Nonhemolytic Pneumolysin

et al. 2006

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Recently, there has been an increase in invasive pneumococcal disease (IPD) caused by serotype 1 Streptococcus pneumoniae throughout Europe. Serotype 1 IPD is associated with bacteremia and pneumonia in Europe and North America, especially in neonates, and is ranked among the top five most prevalent pneumococcal serotypes in at least 10 countries. The currently licensed pediatric pneumococcal vaccine does not afford protection to this serotype. Upon screening of 252 clinical isolates of S. pneumoniae, we discovered mutations in the pneumolysin gene of two out of the four serotype 1 strains present in the study group. Analysis of an additional 28 serotype 1 isolates from patients with IPD from various Scottish Health Boards, revealed that >50% had mutations in their pneumolysin genes. This resulted in the expression of nonhemolytic forms of pneumolysin. All of the strains producing nonhemolytic pneumolysin were sequence type 306 (ST306), whereas those producing "wild-type" pneumolysin were ST227. The mutations were in a region of pneumolysin involved in pore formation. These mutations can be made in vitro to give the nonhemolytic phenotype. Pneumolysin is generally conserved throughout all serotypes of S. pneumoniae and is essential for full invasive disease; however, it appears that serotype 1 ST306 does not require hemolytically active pneumolysin to cause IPD.

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Culture-Negative Childhood Empyema Is Usually Due to Penicillin-Sensitive Streptococcus pneumoniae Capsular Serotype 1

Cited by 54 publications

References 3 publications

Distribution of Streptococcus pneumoniae Serotypes That Cause Parapneumonic Empyema in Turkey

Distribution of Streptococcus pneumoniae Serotypes That Cause Parapneumonic Empyema in Turkey

Temporal Trends of Invasive Disease Due to Streptococcus pneumoniae among Children in the Intermountain West: Emergence of Nonvaccine Serogroups

Identification of Invasive Serotype 1 Pneumococcal Isolates That Express Nonhemolytic Pneumolysin

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