More than 65,000 people develop pleural infections in the US and UK combined each year.[4]Brims FJ, Lansley SM, Waterer GW, et al. Empyema thoracis: new insights into an old disease. Eur Respir Rev. 2010 Sep;19(117):220-8.
https://err.ersjournals.com/content/19/117/220.long
http://www.ncbi.nlm.nih.gov/pubmed/20956197?tool=bestpractice.com
One study of working-age adults in the US found an overall incidence rate of community-acquired pneumonia of 10.6 in 1000 person-years.[5]Broulette J, Yu H, Pyenson B, et al. The incidence rate and economic burden of community-acquired pneumonia in a working-age population. Am Health Drug Benefits. 2013 Sep;6(8):494-503.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031734
http://www.ncbi.nlm.nih.gov/pubmed/24991378?tool=bestpractice.com
Another study found that the incidence of non-ventilator hospital-acquired pneumonia in the US is 3.63 in 1000 patient-days.[6]Giuliano KK, Baker D, Quinn B. The epidemiology of nonventilator hospital-acquired pneumonia in the United States. Am J Infect Control. 2018 Mar;46(3):322-7.
https://www.ajicjournal.org/article/S0196-6553(17)31056-8/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/29050905?tool=bestpractice.com
Parapneumonic effusions may be caused by either community-acquired or hospital-acquired pneumonia. Between 20% and 57% of the 1 million patients hospitalised each year in the US with pneumonia develop a parapneumonic effusion.[7]Sahn SA. Diagnosis and management of parapneumonic effusions and empyema. Clin Infect Dis. 2007 Dec 1;45(11):1480-6.
https://academic.oup.com/cid/article/45/11/1480/334422
http://www.ncbi.nlm.nih.gov/pubmed/17990232?tool=bestpractice.com
Approximately 5% to 10% of parapneumonic effusions develop into empyemas.[8]Shen KR, Bribriesco A, Crabtree T, et al. The American Association for Thoracic Surgery consensus guidelines for the management of empyema. J Thorac Cardiovasc Surg. 2017 Jun;153(6):e129-46.
https://www.jtcvs.org/article/S0022-5223(17)30152-6/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/28274565?tool=bestpractice.com
There is some evidence that empyema is increasing in incidence in both adults and children, the reason for which is unknown.[9]Roxburgh CS, Youngson GG. Childhood empyema in North-East Scotland over the past 15 years. Scott Med J. 2007 Nov;52(4):25-7.
http://www.ncbi.nlm.nih.gov/pubmed/18092633?tool=bestpractice.com
[10]Desrumaux A, Francois P, Pascal C, et al. Epidemiology and clinical characteristics of childhood parapneumonic empyemas [in French]. Arch Pediatr. 2007 Nov;14(11):1298-303.
http://www.ncbi.nlm.nih.gov/pubmed/17631988?tool=bestpractice.com
[11]Munoz-Almagro C, Jordan I, Gene A, et al. Emergence of invasive pneumococcal disease caused by nonvaccine serotypes in the era of 7-valent conjugate vaccine. Clin Infect Dis. 2008 Jan 15;46(2):174-82.
http://cid.oxfordjournals.org/content/46/2/174.full
http://www.ncbi.nlm.nih.gov/pubmed/18171247?tool=bestpractice.com
[12]Finley C, Clifton J, Fitzgerald JM, et al. Empyema: an increasing concern in Canada. Can Respir J. 2008 Mar;15(2):85-9.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677840
http://www.ncbi.nlm.nih.gov/pubmed/18354748?tool=bestpractice.com
[13]Farjah F, Symons RG, Krishnadasan B, et al. Management of pleural space infections: a population-based analysis. J Thorac Cardiovasc Surg. 2007 Feb;133(2):346-51.
https://www.jtcvs.org/article/S0022-5223(06)01861-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/17258562?tool=bestpractice.com
[14]Arnold DT, Hamilton FW, Morris TT, et al. Epidemiology of pleural empyema in English hospitals and the impact of influenza. Eur Respir J. 2021 Jun 17;57(6):2003546.
https://erj.ersjournals.com/content/57/6/2003546
http://www.ncbi.nlm.nih.gov/pubmed/33334937?tool=bestpractice.com
Empyema is more common in men, with a male to female ratio of approximately 2:1. It also has a bi-modal age distribution, occurring more in the sixth or seventh decade of life and in young children.[14]Arnold DT, Hamilton FW, Morris TT, et al. Epidemiology of pleural empyema in English hospitals and the impact of influenza. Eur Respir J. 2021 Jun 17;57(6):2003546.
https://erj.ersjournals.com/content/57/6/2003546
http://www.ncbi.nlm.nih.gov/pubmed/33334937?tool=bestpractice.com
The incidence of parapneumonic effusion and empyema is approximately 3.3 in 100,000 children per year, and there is some evidence that this figure is increasing.[15]Hardie W, Bokulic R, Garcia VF, et al. Pneumococcal pleural empyemas in children. Clin Infect Dis. 1996 Jun;22(6):1057-63.
http://www.ncbi.nlm.nih.gov/pubmed/8783710?tool=bestpractice.com
[16]Rees JH, Spencer DA, Parikh D, et al. Increase in incidence of childhood empyema in West Midlands, UK. Lancet. 1997 Feb 8;349(9049):402.
http://www.ncbi.nlm.nih.gov/pubmed/9033476?tool=bestpractice.com