a Department of Paediatrics , University of Thessaly, School of Health Sciences, Faculty of Medicine , Larissa , Greece ;
b Department of Radiology , University of Thessaly, School of Health Sciences, Faculty of Medicine , Larissa , Greece ;
Infect Dis (Lond). 2016 Oct;48(10):749-53. doi: 10.1080/23744235.2016.1192720. Epub 2016 Jun 20.
Parapneumonic effusions in children are usually associated with pneumococcal infections. In Greece, the 7-valent pneumococcal conjugate vaccine was replaced by higher-valent pneumococcal conjugate vaccines (PCVs); 10-valent was introduced in May 2009 and 13-valent (PCV13) in June 2010. Since July 2010, PCV13 has been the most commonly used PCV. In a study conducted at the University General Hospital of Larissa, Central Greece, from January 2012 to January 2016, 85.7% of children born after the implementation of PCV13 and aged 24-59 months had received the complete series (3 + 1 immunization schedule) of PCV13.
We studied all paediatric community-acquired pneumonia cases with empyema hospitalized at the University General Hospital of Larissa from January 2008 to January 2016.
There were 30 cases of parapneumonic empyema. Among 27 empyema cases of known aetiology, 19 (70.4%) were due to Streptococcus pneumoniae (identifiable serotypes 3, 19A, 7F, and 9N/L). After September 2011, no more cases caused by serotypes 7F and 19A were observed, whereas serotype 3 emerged as the predominant pathogen of pneumococcal empyema (9 of 11 cases). Serotype 3 continued to cause empyema despite vaccination with PCV13 either fully with a 3 + 1 schedule (n = 3) or with one booster dose at the age of 21 months (n = 1).
In Central Greece during the first five years of high coverage with PCV13, serotype 3 was the only PCV13 serotype that clearly persisted in children with empyema.
儿童肺炎旁胸腔积液通常与肺炎球菌感染有关。在希腊，7 价肺炎球菌结合疫苗已被更高价的肺炎球菌结合疫苗（PCV）取代；10 价疫苗于 2009 年 5 月推出，13 价（PCV13）于 2010 年 6 月推出。自 2010 年 7 月以来，PCV13 是最常用的 PCV。在希腊中部拉里萨大学综合医院进行的一项研究中，2012 年 1 月至 2016 年 1 月，实施 PCV13 后出生且年龄在 24-59 个月的儿童中，85.7%已接受了 PCV13 的完整系列（3+1 免疫程序）。
我们研究了 2008 年 1 月至 2016 年 1 月在拉里萨大学综合医院住院的所有小儿社区获得性肺炎合并脓胸的病例。
有 30 例肺炎旁胸腔积液。在 27 例已知病因的脓胸病例中，19 例（70.4%）由肺炎链球菌引起（可识别血清型 3、19A、7F 和 9N/L）。2011 年 9 月以后，不再观察到血清型 7F 和 19A 引起的病例，而血清型 3 则成为肺炎球菌脓胸的主要病原体（11 例中有 9 例）。尽管采用 3+1 方案（n=3）或在 21 个月时接种一剂加强针（n=1）完全接种 PCV13，血清型 3 仍继续导致脓胸。
在希腊中部，在 PCV13 高覆盖率的头五年中，血清型 3 是唯一在脓胸患儿中持续存在的 PCV13 血清型。
