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Volume 14, Number 9—September 2008

Pediatric Parapneumonic Empyema, Spain

Ignacio ObandoComments to Author , Carmen Muñoz-Almagro, Luis A. Arroyo, David Tarrago, David Sanchez-Tatay, David Moreno-Perez, Sahar S. Dhillon, Cristina Esteva, Susanna Hernandez-Bou, Juan J. Garcia-Garcia, William P. Hausdorff, and Angela B. Brueggemann
Author affiliations: Virgen del Rocio Children’s Hospital, Seville, Spain (I. Obando, L.A. Arroyo, D. Sanchez-Tatay); Sant Joan de Deu Hospital, Barcelona, Spain (C. Muñoz-Almagro, C. Esteva, S. Hernandez-Bou, J.J. Garcia-Garcia); Spanish Reference Laboratory for Pneumococci, Madrid, Spain (D. Tarrago); Carlos de Haya Children’s Hospital, Malaga, Spain (D. Moreno-Perez); University of Oxford, Oxford, UK (S.S. Dhillon, A.B. Brueggemann);; GlaxoSmithKline Biologicals, Rixensart, Belgium (W.P. Hausdorff);

Main Article

Table 4

Contribution of PPE-associated serotypes and STs to IPD, Seville and Malaga, 2001–2006, and nasopharyngeal carriage in children <6 years of age, Seville*†

Serotype No. (%) patients with IPD, n = 126 STs detected: diseases detected 
(no. patients), n = 111 Carriage, no. (%) patients, n = 194 STs detected in carriage (no. patients) OR (95% CI)
1 29 (23) 228: P (7), PPE (6), A (1), B (1) 1 (1) 306 (1) 57.7 (7.7–429.9)
306‡ : PPE (7), P (3)

304§: PPE (1)

14 22 (17) 156: P (7), PPE (4), M (2) 15 (8) 156 (12) 2.5 (1.3–5.1)
9: PPE (1) 409 (1)
62: P (1) 1684 (1)
124: PPE (1) 2607 (1)

2204: M (1)

10 (8)
191: PPE (4), P (3), M (1), B (1)
3 (2)
191 (3)
5.5 (1.5–20.3)
19A 10 (8) 276: PPE (2), M (2), P (1) 13 (7) 276 (2) 1.2 (0.5–2.8)
202: B (1) 202 (3)
1201: PPE (1) 1201 (1)
199 (2)
433 (2)
392 (1)
2109 (1)

2609 (1)

3 6 (5) 260: PPE (1), P (1), M (1) 7 (4) 180 (3) 1.6 (0.5–4.6)
180: PPE (1) 260 (2)

2200 (2)

6A 5 (4) 1150: M (1) 24 (12) 338 (8) 0.29 (0.1–0.79)
1668: S (1) 386 (5)
1876: M (1) 1876 (3)
224 (2)
327 (1)
392 (1)
448 (1)
473 (1)
2201 (1)

2611 (1)

5 3 (2) 289: PPE (2) 2 (1) 289 (1) 2.3 (0.39–14.2)

1223: P (1)

1540 (1)

19F 3 (2) 87: C (1), B (1) 8 (4) 81 (3) 0.57 (0.15–2.2)
88: M (1) 87 (1)
179 (2)
63 (1)

2615 (1)

1 (1)
838: B (1)
3 (2)
838 (3)
0.5 (0.05–5)
8 1 (1) 53: M (1) 0

*Culture-positive isolates only for IPD. Boldface indicates a statistically significant result and represents STs that were identified among pleural fluids during the study period in Seville, Malaga, and Barcelona. An OR demonstrating the potential for each serotype to cause invasive disease, relative to its prevalence in nasopharyngeal carriage, was also calculated (16). Serotypes 6A, 19F, and 9V were associated with PPE in Barcelona (but not Seville and Malaga) and are included here for a complete list of invasive serotypes with any association to PPE among the 3 locations; however, data presented here are only from Seville and Malaga. Serotypes identified in IPD cases but not among children with PPE: 6B, 11, 13, 15A, 16, 18C, 22, 23A, 23B, 23F, 24, 33, 34, 38.
†PPE, pediatric parapneumonic empyema; IPD, invasive pneumococcal disease; ST, sequence type; OR, odds ratio; CI, confidence interval; A, arthritis; B, occult bacteremia; P, pneumonia; M, meningitis; S, sepsis; C, orbital cellulitis.
‡First detected in 2003.
§First detected in 2002.

Main Article

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