ADULT ALL-CAUSE AND PNEUMOCOCCAL PARAPNEUMONIC EMPYEMA HOSPITALIZATION RATES IN THE ERA OF DECLINING INVASIVE PNEUMOCOCCAL DISEASE AFTER PCVS INTRODUCTION IN THE US (ID 1176)
- Andrew D. Wiese, United States of America
- Andrew D. Wiese, United States of America
- Marie R. Griffin, United States of America
- Carlos Grijalva, United States of America
Abstract
Background
Parapneumonic empyema, a severe pneumonia complication, increased among US adults (especially older adults) after the introduction of 7-valent pneumococcal conjugate vaccine (PCV7), though the trend since PCV13 introduction remains unclear. We examined parapneumonic and pneumococcal empyema hospitalization rates among US adults during the PCVs era.
Methods
National Inpatient Sample and Census Data were used to calculate national annual all-cause and pneumococcal parapneumonic empyema hospitalization rates among adults. Rates were compared to national invasive pneumococcal disease (IPD) estimates from the CDC Active Bacterial Core surveillance system (1997-2017). We examined age-specific rates by vaccine era [pre-PCV7 (1997-1999); PCV7 (2001-2009); early-PCV13 era (2011-2015); and late-PCV13 (2016-2017) after transition from ICD9 to ICD10 codes].
Results
All-cause parapneumonic empyema hospitalization rates increased in every adult age group during the study period (Table). Pneumococcal parapneumonic empyema hospitalization rates followed similar trends as overall IPD and declined in every age group after PCV13 introduction (Figure). Modest increases were observed after PCV13 introduction for streptococcal parapneumonic empyema and parapneumonic empyema without an identified causative organism.
Conclusions
While the rate of all-cause parapneumonic empyema hospitalizations among US adults has increased in the last 2 decades, modest changes have been observed in pneumococcal parapneumonic empyema with declines following PCV13 introduction.