Pneumococcal epidemiology among us adults hospitalized for community-acquired pneumonia
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Authors
Isturiz, Raul E.Ramirez, Julio
Self, Wesley H.
Grijalva, Carlos G.
Counselman, Francis L.
Volturo, Gregory A.
Ostrosky-Zeichner, Luis
Peyrani, Paula
Wunderink, Richard G.
Sherwin, Robert
Overcash, J. Scott
Oliva, Senen Pena
File, Thomas
Wiemken, Timothy L.
McLaughlin, John M.
Pride, Michael W.
Gray, Sharon
Alexander, Ronika
Ford, Kimbal D.
Jiang, Qin
Jodar, Luis
UMass Chan Affiliations
Department of Emergency MedicineDocument Type
Journal ArticlePublication Date
2019-05-31Keywords
CommunityPneumococcus
Pneumonia
Streptococcus
Bacterial Infections and Mycoses
Clinical Epidemiology
Community Health and Preventive Medicine
Epidemiology
Respiratory Tract Diseases
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BACKGROUND: Few studies have measured the burden of adult pneumococcal disease after the introduction of 13-valent pneumococcal conjugate vaccine (PCV13) into the US infant vaccination schedule. Further, most data regarding pneumococcal serotypes are derived from invasive pneumococcal disease (IPD), which represents only a fraction of all adult pneumococcal disease burden. Understanding which pneumococcal serotypes cause pneumonia in adults is critical for informing current immunization policy. The objective of this study was to measure the proportion of radiographically-confirmed (CXR+) community-acquired pneumonia (CAP) caused by PCV13 serotypes in hospitalized US adults. METHODS: This observational, prospective surveillance study recruited hospitalized adults aged > /=18years from 21 acute care hospitals across 10 geographically-dispersed cities in the United States between October 2013 and September 2016. Clinical and demographic data were collected during hospitalization. Vital status was ascertained 30days after enrollment. Pneumococcal serotypes were detected via culture from the respiratory tract and normally-sterile sites (including blood and pleural fluid). Additionally, a novel, Luminex-based serotype-specific urinary antigen detection (UAD) assay was used to detect serotypes included in PCV13. RESULTS: Of 15,572 enrolled participants, 12,055 eligible patients with CXR+CAP were included in the final analysis population. Mean age was 64.1years and 52.7% were aged > /=65years. Common comorbidities included chronic obstructive pulmonary disease (43.0%) and diabetes mellitus (28.6%). PCV13 serotypes were detected in 552/12,055 (4.6%) of all patients and 265/6347 (4.2%) of those aged > /=65years. Among patients aged 18-64years PCV13 serotypes were detected in 3.8-5.3% of patients depending on their risk status. CONCLUSIONS: After implementation of a pneumococcal conjugate vaccination program in US children, and despite the herd protection observed in US adults, a persistent burden of PCV13-type CAP remains in this population.Source
Vaccine. 2019 May 31;37(25):3352-3361. doi: 10.1016/j.vaccine.2019.04.087. Epub 2019 May 6. Link to article on publisher's site
DOI
10.1016/j.vaccine.2019.04.087Permanent Link to this Item
http://hdl.handle.net/20.500.14038/41074PubMed ID
31072732Related Resources
Rights
Copyright 2019 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Distribution License
http://creativecommons.org/licenses/by/4.0/ae974a485f413a2113503eed53cd6c53
10.1016/j.vaccine.2019.04.087
Scopus Count
Except where otherwise noted, this item's license is described as Copyright 2019 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).