TY - JOUR T1 - National surveillance of paediatric empyema in the UK; the UK-ESPE study JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P2946 AU - David Spencer AU - Matthew Thomas AU - Elemraid Mohammed AU - Julia Clark AU - Steve Rushton AU - Jimmy Paton Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P2946.abstract N2 - UK-ESPE monitors the changing empyema epidemiology and compares management across the UK. Demographic, clinical and microbiological data on children undergoing pleural drainage were obtained from 19 paediatric respiratory centres from September 2006-March 2011. Culture negative pleural fluid underwent pneumococcal PCR, positive samples were serotyped using an assay detecting 14 serotypes/groups. Robust multivariate survival models were used to analyse length of stay (LOS). Chi-squared, Kruskal-Wallis and Fisher's test were used for other analyses. Data on 635 children were obtained (56% male, median age 4.3 years). If a bacterial cause was found (n=287), Streptococcus pneumoniae accounted for 68%, Streptococcus pyogenes 14% and Staphylococcus aureus 4%. A pneumococcal serotype was detected in 125 patients with serotype 1(46%), 3(22%), 7(12%) and 19A(9%). PCV-7 serotypes accounted for 48% in 2006/07 but had disappeared by 2010/11. Non-PCV-7 serotypes increased over the same period. 19A was associated with severe disease and the only reported death. Median tertiary LOS was 8 days (range 3-33) and median total hospital stay (THS) 11 days (range 5-43). Surgery was associated with a decrease in tertiary LOS of 41% (95% C.I.7-88%, p=0.015) and THS of 43% (95% C.I .7-92%, p=0.015) compared to non-surgical treatment. This effect did not achieve significance when each treatment group was analysed separately. Empyema in the UK remains predominantly a pneumococcal disease with causative serotypes changing over time. Continuing surveillance is required to monitor changes following introduction of new pneumococcal vaccines. Primary surgical strategies were associated with reduced hospital stay in this cohort. ER -