{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T21:46:51Z","timestamp":1776203211850,"version":"3.50.1"},"reference-count":45,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The incidence of childhood empyema has been increasing in some developed countries despite the introduction of pneumococcal vaccination. This study aimed to document the incidence, bacterial pathogens, and morbidity\/mortality of parapneumonic effusion\/empyema in New Zealand.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective study of 102 children &lt;15 years of age requiring hospitalization with parapneumonic effusion\/empyema between May 1, 2014 and May 31, 2016 notified via the New Zealand Paediatric Surveillance Unit. Parapneumonic effusion\/empyema was defined as pneumonia and pleural effusion persisting \u22657 days, and\/or any pneumonia, and pleural effusion necessitating drainage. Notifying pediatricians completed standardized questionnaires.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Annual pediatric parapneumonic effusion\/empyema incidence was 5.6\/100,000 (95% confidence interval [CI]: 4.7\u20136.9). Most children (80%) required surgical intervention and 31% required intensive care. A causative organism was identified in 71\/102 (70%) cases. Although <jats:italic>Staphylococcus aureus<\/jats:italic> (25%) and <jats:italic>Streptococcus pneumoniae<\/jats:italic> (25%) infection rates were equal, prolonged hospitalization and intensive care admission were more common in children with <jats:italic>S. aureus<\/jats:italic> PPE\/E. M\u0101ori and Pasifika children were over\u2010represented at 2.2 and 3.5 times, their representation in the New Zealand pediatric population. Pneumococcal vaccination was incomplete, with only 61% fully immunized and 30% unimmunized. <jats:italic>Haemophilus influenzae<\/jats:italic> type b vaccine uptake was near complete at 89\/94 (95%), with influenza immunization only 3\/78 (4%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>New Zealand has a high incidence of pediatric complicated parapneumonic effusion\/empyema with significant morbidity. <jats:italic>S. aureus<\/jats:italic> was a significant cause of severe empyema in New Zealand, particularly for M\u0101ori and Pasifika children. Improvements in vaccine coverage are needed along with strategies to reduce <jats:italic>S. aureus<\/jats:italic> disease morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.25564","type":"journal-article","created":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T17:23:21Z","timestamp":1625678601000},"page":"2949-2957","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Surveillance of pediatric parapneumonic effusion\/empyema in New Zealand"],"prefix":"10.1002","volume":"56","author":[{"given":"Katherine","family":"Rix\u2010Trott","sequence":"first","affiliation":[{"name":"Starship Children's Health Auckland District Health Board  Auckland New Zealand"},{"name":"KidzFirst Children's Hospital Counties Manukau District Health Board  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3032-3172","authenticated-orcid":false,"given":"Catherine 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