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dc.contributor.authorBewick, Thomas
dc.contributor.authorSheppard, Carmen L.
dc.contributor.authorGreenwood, Sonia
dc.contributor.authorSlack, Mary P. E.
dc.contributor.authorTrotter, Caroline L.
dc.contributor.authorGeorge, Robert
dc.contributor.authorLim, Wei Shen
dc.description.abstractSerotypes 1, 3, 7F and 19A are implicated in childhood pneumococcal para-pneumonic effusion (PPE). It is not known whether the same is true for adult PPE. A prospective cohort study was conducted over a 2-year period. Consecutive adults admitted with community-acquired pneumonia (CAP) were studied. Pneumococcal serotype was identified from urine samples using a multiplex immunoassay. Of 920 patients recruited, 366 had pneumococcal CAP; 100 of these had PPE and a serotype was determined in 73 patients. Factors associated with PPE were age, pneumonia severity index score and serotype. Serotypes most associated with PPE were 1 (18 (45%) out of 40), 19A (9 (45%) out of 20) and 3 (8 (40%) out of 20). Serotypes common in childhood PPE were independently associated with adult PPE (adjusted OR 2.3; p = 0.003). Serotypes not included in the 7-valent pneumococcal conjugate vaccine (PCV) were more likely to be associated with PPE (OR 2.1; p = 0.024) compared with those in the vaccine. Serotypes included in PCV-13 were as likely to be associated with PPE as those that are not (OR 0.8; p = 0.301). Serotypes 1, 3, 7F and 19A are independently associated with adult PPE, a similar finding to childhood PPE. Serotype replacement following pneumococcal vaccine implementation may influence the spectrum of clinical disease.en_US
dc.publisherEuropean Respiratory Societyen_US
dc.relation.ispartofjournalEuropean Respiratory Journalen_US
dc.subject.fieldofresearchClinical Microbiologyen_US
dc.titleSerotypes associated with the development of pneumococcal para-pneumonic effusion in adultsen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Peer Reviewed (HERDC)en_US
dc.type.codeC - Journal Articlesen_US
gro.rights.copyrightSelf-archiving of the author-manuscript version is not yet supported by this journal. Please refer to the journal link for access to the definitive, published version or contact the authors for more information.en_US
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