ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2010
Increasing incidence of empyema complicating childhood community-acquired pneumonia in the United States.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 6 of them syntheses that pooled it.
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Who cites it
73 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Early Versus Late(r) Administration of Intrapleural Fibrinolytic Therapy in Children with Empyema: A Systematic Review and Meta-Analysis.Indian pediatrics · 2026Pooled it
- Microbial Etiology of Empyema Thoracis in Children: A Systematic Review and Meta-Analysis.Indian pediatrics · 2026Pooled it
- Comparative Efficacy, Safety, and Cost of Different Intrapleural Fibrinolytic Agents for the Management of Empyema Thoracis in Children: A Systematic Review.Indian pediatrics · 2026Pooled it
- Complicated pneumococcal pneumonia in the era of higher-valent pneumococcal conjugate vaccines: a systematic literature review and meta-analysis, 2001-2022.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Pooled it
- Systematic review of the effect of pneumococcal conjugate vaccine dosing schedules on prevention of pneumonia.The Pediatric infectious disease journal · 2014Pooled it
- Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis.Lancet (London, England) · 2013Pooled it
- BinaxNOWClinical pediatrics · 2026Article
- Observational
- Pediatric Emergency Tube Thoracostomy: Complications and Independent Risk Factors in a Five-Year Cohort.Sisli Etfal Hastanesi tip bulteni · 2026Article
- Pulmonary function in children post-empyema: spirometryERJ open research · 2025Article
- Diversity in the composition of pleural cavity and oral cavity microbiota in different bacterial empyema.Frontiers in microbiology · 2025Article
- Glycyrrhetinic acid reduces lung inflammation caused by pneumococcal infection by reducing the toxicity of pneumolysin.Heliyon · 2024Article
- The role of the early video-assisted thoracoscopic surgery in children with pleural empyema.Pediatric surgery international · 2024Observational
- Children hospitalized with community-acquired pneumonia complicated by effusion: a single-centre retrospective cohort study.BMC pediatrics · 2023Article
- Burden of all-cause and organism-specific parapneumonic empyema hospitalization rates prior to the SARS-CoV-2 pandemic in the United States.Respiratory medicine · 2023Article
- Community-acquired pneumonia in hospitalised patients: changes in aetiology, clinical presentation, and severity outcomes in a 10-year period.Annals of medicine · 2022Article
- Article
- Incidence of Acute Chest Syndrome in Children With Sickle Cell Disease Following Implementation of the 13-Valent Pneumococcal Conjugate Vaccine in France.JAMA network open · 2022Article
- Childhood pneumonia in New Zealand.Journal of paediatrics and child health · 2022Article
- The impact of pneumococcal conjugate vaccine on the prevalence and severity of hospitalizations for pneumonia in children.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
13 more citing papers are in PubMed but not listed here.
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4 authors.
Funding
Abstract
backgroundThe incidence of childhood pneumonia decreased following introduction of 7-valent pneumococcal conjugate vaccine (PCV7) in the United States. Recent regional reports suggest an increase in the incidence of childhood pneumonia complicated by empyema. We assessed whether early decreases in pneumonia hospitalization rates were sustained and trends in such hospitalizations complicated by empyema in United States children aged <5 years.
methodsNationwide Inpatient Sample and Census data were used to calculate annual all-cause and pneumococcal pneumonia hospitalization rates for pre-PCV7 (1996-1999) and post-PCV7 years (2001-2007) and to analyze national trends in total and pathogen-specific pneumonia-associated empyema.
resultsAmong children aged <2 years, all-cause pneumonia hospitalizations decreased 33% (95% confidence interval, 28%-37%) from 1267 cases per 100,000 children in pre-PCV7 years to 852 cases per 100,000 children in post-PCV7 years. Pneumococcal pneumonia hospitalization rates decreased 61% (95% confidence interval, 55%-67%) post-PCV7, compared with pre-PCV7 years. Pneumonia hospitalizations complicated by empyema increased 2.01-fold from 3.5 cases per 100,000 children in 1996-1998 to 7.0 cases per 100,000 children in 2005-2007. Rates of pneumococcal and streptococcal empyema remained stable, whereas rates of staphylococcal and other or unspecified empyema increased 4.08- and 1.89-fold, respectively. Among children aged 2-4 years, all-cause pneumonia rates remained stable, whereas pneumococcal pneumonia decreased by 26% (95% confidence interval, 16-34). Pneumonia complicated by empyema increased 2.81-fold from 3.7 cases per 100,000 children in 1996-1998 to 10.3 cases per 100,000 children in 2005-2007. In this age group, there were 2.17-, 2.80-, 3.76-, and 3.09-fold increases in rates of pneumococcal, streptococcal, staphylococcal, and other or unspecified empyema, respectively.
conclusionDecreases in childhood pneumonia hospitalization rates following PCV7 introduction were sustained. Although empyema complicated only a small fraction of pneumonia hospitalizations, its prevalence increased substantially. This increase was due to several pathogens and warrants continuing monitoring.
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