Serotypes associated with the development of pneumococcal para-pneumonic effusion in adults

Thomas Bewick*, Carmen Sheppard, Sonia Greenwood, Mary Slack, Caroline Trotter, Robert George, Wei Shen Lim

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

14 Citations (Scopus)

Abstract

Serotypes 1, 3, 7F and 19A are implicated in childhood pneumococcal para-pneumonic effusion (PPE). It is not known whether the same is true for adult PPE.

A prospective cohort study was conducted over a 2-year period. Consecutive adults admitted with community-acquired pneumonia (CAP) were studied. Pneumococcal serotype was identified from urine samples using a multiplex immunoassay.

Of 920 patients recruited, 366 had pneumococcal CAP; 100 of these had PPE and a serotype was determined in 73 patients. Factors associated with PPE were age, pneumonia severity index score and serotype. Serotypes most associated with PPE were 1 (18 (45%) out of 40), 19A (9 (45%) out of 20) and 3 (8 (40%) out of 20). Serotypes common in childhood PPE were independently associated with adult PPE (adjusted OR 2.3; p=0.003). Serotypes not included in the 7-valent pneumococcal conjugate vaccine (PCV) were more likely to be associated with PPE (OR 2.1; p=0.024) compared with those in the vaccine. Serotypes included in PCV-13 were as likely to be associated with PPE as those that are not (OR 0.8; p=0.301).

Serotypes 1, 3, 7F and 19A are independently associated with adult PPE, a similar finding to childhood PPE. Serotype replacement following pneumococcal vaccine implementation may influence the spectrum of clinical disease.

Original languageEnglish
Pages (from-to)733-741
Number of pages9
JournalEuropean Respiratory Journal
Volume42
Issue number3
DOIs
Publication statusPublished - Sep 2013

Keywords

  • COMMUNITY-ACQUIRED PNEUMONIA
  • STREPTOCOCCUS-PNEUMONIAE
  • CONJUGATE VACCINE
  • PARAPNEUMONIC EFFUSIONS
  • PREDICTION RULE
  • PLEURAL FLUID
  • EMPYEMA
  • DIAGNOSIS
  • CHILDREN
  • EPIDEMIOLOGY

Cite this

Bewick, T., Sheppard, C., Greenwood, S., Slack, M., Trotter, C., George, R., & Lim, W. S. (2013). Serotypes associated with the development of pneumococcal para-pneumonic effusion in adults. European Respiratory Journal, 42(3), 733-741. https://doi.org/10.1183/09031936.00144712