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.
Abstract
Serotypes associated with pneumococcal para-pneumonic effusion in adults are similar to those in childhood disease http://ow.ly/l0nxw
Footnotes
Support statement: This work was supported by an unrestricted grant from Pfizer. The study was conceived by the authors and the study design was developed and agreed by the authors without any input from the funding body. The study concept and design was peer reviewed by an independent reviewer prior to ethics approval and prior to award of the grant from the funding body. The funding body was not involved in, nor had any influence over, study design, data collection, data analyses, interpretation of results, report writing, or in the decision to submit the paper for publication. All study data are held solely by the authors. The sponsor for the study was Nottingham University Hospitals NHS Trust. The authors are grateful to Alere (Stockport, UK; formerly Inverness Medical) for manufacturing and providing Binax NOW® test kits.
Conflict of interest: Disclosures can be found alongside the online version of this article at www.erj.ersjournals.com
- Received September 12, 2012.
- Accepted November 25, 2012.
- ©ERS 2013