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An epidemiological investigation of a sustained high rate of pediatric parapneumonic empyema: risk factors and microbiological associations.

Abstract
We investigated the increasing incidence of pediatric empyema during the 1990s at Primary Children's Medical Center in Salt Lake City. Of 540 children hospitalized with community-acquired bacterial pneumonia (CAP) who were discharged from 1 July 1993 through 1 July 1999, 153 (28.3%) had empyema. The annual population incidence of empyema increased during the study period from 1 to 5 cases per 100,000 population aged <19 years. Streptococcus pneumoniae was identified as the most common cause of CAP with or without empyema; serotype 1 accounted for 50% of the cases of pneumococcal empyema. Patients with empyema were more likely to be >3 years old, to have > or =7 days of fever, to have varicella, and to have received antibiotics and ibuprofen before admission to the hospital, compared with patients without empyema (P<.0001 for each factor). The increasing incidence of empyema was associated with infection due to S. pneumoniae serotype 1, outpatient treatment with certain antibiotics, ibuprofen use, and varicella.
AuthorsCarrie L Byington, LaShonda Y Spencer, Timothy A Johnson, Andrew T Pavia, Daniel Allen, Edward O Mason, Sheldon Kaplan, Karen C Carroll, Judy A Daly, John C Christenson, Matthew H Samore
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 34 Issue 4 Pg. 434-40 (Feb 15 2002) ISSN: 1537-6591 [Electronic] United States
PMID11797168 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Child
  • Child, Preschool
  • Community-Acquired Infections (complications, epidemiology, microbiology)
  • Empyema (epidemiology, etiology)
  • Female
  • Humans
  • Incidence
  • Male
  • Pneumonia, Pneumococcal (complications, epidemiology, microbiology)
  • Risk Factors
  • Serotyping
  • Streptococcus pneumoniae

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