COUCHE study: characteristics and outcomes of children hospitalised with pleural empyema

Project status: Active

Research area: Infection, Immunity & Global Health > Respiratory research

Understanding Pleural Empyema in children hospitalised in Melbourne, Australia, over an eight‑year period.

The COUCHE study is a major collaborative research initiative between Murdoch Children’s Research Institute (MCRI) Respiratory research group, the Centre for Health Analytics (Melbourne Children’s Campus), and our industry partner MSD-Australia.

What is the COUCHE Study?

This retrospective study reviews cases of children admitted to The Royal Children’s Hospital (RCH) with pleural empyema between 2016 and 2024.

It examines clinical features, treatment interventions and patient outcomes across pre-pandemic, pandemic, and post-pandemic periods. It specifically looks at the rates of necrotising lung disease and microbiological pathogens over time.

Key findings

Our preliminary findings reveal:

Overall rise in empyema cases over the eight-year period.
High rates of necrotising pneumonia.
Shifts in pathogen patterns, with:
- Streptococcus pneumoniae remaining the dominant pathogen
- Serotype 3 was dominant on a subset that underwent serotyping
- Notable increases in Group A Streptococcus and respiratory viruses such as influenza and Respiratory syncytial virus (RSV).

These insights are critical for risk stratification, clinical management, and vaccine-prevention strategies.

Why this research matters

Pleural empyema is a serious complication of pneumonia in children. Understanding its epidemiology, pathogen trends, and clinical outcomes helps improve:

Treatment protocols
Preventive strategies
Healthcare resource planning

COUCHE-MATE collaboration

COUCHE-MATE is a collaboration with the Translational Microbiology research group, led by Professor Catherine Satzke (Principal Investigator, MATE study). This collaboration aims to identify Streptococcus pneumoniae serotypes linked to the most severe empyema cases, informing future vaccine development and public health policy.