Pediatric parapneumonic effusion before and after national pneumococcal vaccination programs in Taiwan
Journal
Journal of the Formosan Medical Association
Journal Volume
119
Journal Issue
11
Pages
1608-1618
Date Issued
2020
Author(s)
Abstract
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. ? 2020
SDGs
Other Subjects
C reactive protein; immunoglobulin M; lactate dehydrogenase; Pneumococcus vaccine; Pneumococcus vaccine; vaccine; adolescent; adult; Article; blood analysis; child; clinical assessment; diagnostic test; female; hospital admission; human; incidence; infectious agent; lobar pneumonia; long term care; lung parenchyma; major clinical study; male; medical record; metabolic parameters; Mycoplasma pneumonia; Mycoplasma pneumoniae; parapneumonic effusion; pleura effusion; pleura empyema; pleura fluid; pneumococcal infection; preschool child; respiratory tract parameters; retrospective study; sputum culture; Streptococcus pneumoniae; Taiwan; throat culture; vaccination; complication; immunology; infant; pleura effusion; pneumococcal infection; Streptococcus pneumonia; vaccination; Child; Humans; Infant; Pleural Effusion; Pneumococcal Infections; Pneumococcal Vaccines; Pneumonia, Pneumococcal; Streptococcus pneumoniae; Taiwan; Vaccination; Vaccines, Conjugate
Publisher
Elsevier B.V.
Type
journal article