Empyema Hospitalizations Increased in US Children Despite Pneumococcal Conjugate Vaccine. 2010, Li, Pediatrics

Empyema of the pleura is a complication of pneumonia (accumulation of pus in the cavities surrounding the lungs), which occurs in 3% of cases of pneumonia, and in a third of cases of pneumococcal pneumonia. The incidence of empyema in the US increased by 70% between 1997 and 2006, despite the decrease in cases of bacterial pneumonia and pneumococcus. Among children less than 5 years old, the hospitalization due to pleural empyema increased by 100%.
The incidence of bacterial pneumonia decreased by 13% The incidence of invasive pneumococcus decreased by 50%. Your complications of pneumonia increased by 44%.


Emergence of invasive pneumococcal disease caused by nonvaccine serotypes in the era of 7-valent conjugate vaccine. 2008, Muñoz-Almagro, Clin Infect Dis

After the start of vaccination, the incidence of pneumococcal infection in Barcelona increased by 58%, and among children by 135%.
The incidence of vaccine serotypes decreased by 40%, and the non-vaccine serotypes increased by 531%.
Incidence of pneumonia and empyema among children under 5 years old rose by 320%.


Temporal trends of invasive disease due to Streptococcus pneumoniae among children in the intermountain west: the emergence of nonvaccine serogroups. 2005, Byington, Clin Infect Dis

After vaccination began, between 1997 and 2003, the number of cases of pneumococcal infection in Salt Lake City (Utah) decreased by 27%. The incidence of vaccine serotypes decreased from 73% to 50%. The number of cases of non-vaccine serotypes increased The number of cases with complicated pleural empyema increased from 16% to 30%, and the proportion of severe cases increased from 57% to 71%. More: [1].


Invasive pneumococcal disease caused by nonvaccine serotypes among Alaska native children with high levels of 7-valent pneumococcal conjugate vaccine coverage. 2007, Singleton, JAMA

Aboriginal children in Alaska are infected with invasive pneumococcal infection 3 times more often than Americans on average. For the first 3 years after the start of vaccination (2001-2003), the incidence of pneumococcal infection among indigenous children under 2 years of age in Alaska decreased by 67%, but then in 2004-2006, the incidence increased by 82%.
The incidence of vaccine serotypes decreased by 96%, and the non-vaccine serotypes increased by 140%.
The share of cases complicated by pleural empyema increased from 2% to 13%.The share of cases with pneumonia and bacteremia increased from 40% to 57%.
41% of the population were carriers of pneumococcus in 2004. The share of seven vaccine serotypes decreased from 41% to 5%, and of non-vaccine serotypes increased from 47% to 88%.

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