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Archivos de Pediatría del Uruguay

On-line version ISSN 1688-1249

Abstract

MACHADO, Karina et al. Features of parapneumonic empyema after the beginning of pneumococcal vaccination: CHPR, 2010. Arch. Pediatr. Urug. [online]. 2014, vol.85, n.4, pp.212-2219. ISSN 1688-1249.

Summary  Parapneumonic empyema (PE) is a frequent and serious complication of community-acquired pneumonia (CAP), mainly caused by Streptococcus pneumoniae. In Uruguay from 2008 were incorporated neumococcal conjugate vaccines (PCV), which resulted in a decrease in the prevalence of pneumococcal disease and changes in the involved serotypes. A descriptive study was conducted to evaluate the characteristics of children less than 14 years hospitalized for PE in 2010. There were identified 69 patients, representing a rate of 63.4/10.000 of the discharges. The average age was 4 years, 37% of children fewer than 5 years had 3 doses of PCV. Initial presentation was severe, with 30% of cases requiring intensive care admission. Chest drain treatment was received by 96%, intrapleural instillation of streptokinase in 64% and surgery in 6%. The hospitalization had an average of 18 days. A significant percentage of children had complications, one died. In 62% of patients, it was identified an etiology, most S. pneumoniae. The serotypes were similar to those identified before implementation of PCV. No vaccine failures were identified. The EP persists as a serious illness; even the PCV implementation determined it decreased prevalence. No significant changes in the serotypes were detected. It is important the continuing monitoring of the PCV implementation effect in this pathology.

Keywords : EMPYEMA, PLEURAL; PNEUMONIA; COMMUNITY ACQUIRED INFECTIONS; PNEUMOCOCCAL VACCINES.

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