Obando, IgnacioMuñoz-Almagro, CarmenArroyo, Luis ATarrago, DavidSanchez-Tatay, DavidMoreno-Perez, DavidDhillon, Sahar SEsteva, CristinaHernandez-Bou, SusannaGarcia-Garcia, Juan JHausdorff, William PBrueggemann, Angela B2015-01-222015-01-222008-09-09Obando I, Muñoz-Almagro C, Arroyo LA, Tarrago D, Sanchez-Tatay D, Moreno-Perez D, et al. Pediatric parapneumonic empyema, Spain. Emerging Infect. Dis. 2008; 14(9):1390-71080-6040http://hdl.handle.net/10668/1795Journal Article; Research Support, Non-U.S. Gov't;Pediatric parapneumonic empyema (PPE) has been increasing in several countries including Spain. Streptococcus pneumoniae is a major PPE pathogen; however, antimicrobial pretreatment before pleural fluid (PF) sampling frequently results in negative diagnostic cultures, thus greatly underestimating the contribution of pneumococci, especially pneumococci susceptible to antimicrobial agents, to PPE. The study aim was to identify the serotypes and genotypes that cause PPE by using molecular diagnostics and relate these data to disease incidence and severity. A total of 208 children with PPE were prospectively enrolled; blood and PF samples were collected. Pneumococci were detected in 79% of culture-positive and 84% of culture-negative samples. All pneumococci were genotyped by multilocus sequence typing. Serotypes were determined for 111 PPE cases; 48% were serotype 1, of 3 major genotypes previously circulating in Spain. Variance in patient complication rates was statistically significant by serotype. The recent PPE increase is principally due to nonvaccine serotypes, especially the highly invasive serotype 1.enPreescolarEmpiema PleuralGenotipoHumanosLactanteEpidemiología MolecularNeumonía NeumocócicaEstudios ProspectivosEstudios RetrospectivosEspañaStreptococcus pneumoniaeNiñoMedical Subject Headings::Named Groups::Persons::Age Groups::Child::Child, PreschoolMedical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Respiratory Tract Infections::Empyema, PleuralMedical Subject Headings::Phenomena and Processes::Genetic Phenomena::GenotypeMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Named Groups::Persons::Age Groups::InfantMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Molecular EpidemiologyMedical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Streptococcal Infections::Pneumococcal Infections::Pneumonia, PneumococcalMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective StudiesMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective StudiesMedical Subject Headings::Geographicals::Geographic Locations::Europe::SpainMedical Subject Headings::Organisms::Bacteria::Gram-Positive Bacteria::Gram-Positive Cocci::Streptococcaceae::Streptococcus::Streptococcus pneumoniaeMedical Subject Headings::Named Groups::Persons::Age Groups::Childresearch article18760005open access10.3201/eid1409.0710941080-6059PMC2603109