Distribution of 13-Valent Pneumococcal Conjugate Vaccine Streptococcus pneumoniae Serotypes in US Adults Aged >=50 Years With Community-Acquired Pneumonia

Sinai Grace Hospital Emergency Department and Sinai Grace Hospital/Detroit Receiving Hospital, Wayne State University School of Medicine, Detroit, Michigan.
The Journal of Infectious Diseases (Impact Factor: 6). 10/2013; 208(11). DOI: 10.1093/infdis/jit506
Source: PubMed


Streptococcus pneumoniae causes a substantial proportion of community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) in the United States. Limited data are available regarding the pneumococcal serotypes causing CAP and HCAP.

Adults aged ≥ 50 years presenting to participating US hospitals with radiographically confirmed pneumonia between February 2010 and September 2011 were screened for inclusion. S. pneumoniae was identified using microbiological cultures, BinaxNOW® S. pneumoniae assay, or urine antigen detection (UAD) assay capable of detecting 13-valent pneumococcal conjugate vaccine (PCV13)-associated serotypes.

Among 710 subjects enrolled, the median age was 65.4 years; 54.2% of subjects were male, 22.4% of radiographically confirmed pneumonia cases were considered HCAP, and 96.6% of subjects were hospitalized. S. pneumoniae was detected in 98 subjects (13.8%) by any test, and PCV13-associated serotype(s) were identified by UAD in 78 (11.0%). Serotype 19A was most prevalent, followed by 7F/A, 3, and 5. Serotypes associated with 7-valent pneumococcal conjugate vaccine (PCV7) accounted for 25% of UAD-positive isolates.

Pneumococcal serotypes causing noninvasive pneumonia in adults may differ significantly from those causing invasive disease, with PCV7-associated serotypes overrepresented. Serotype 5, rarely seen in contemporary surveillance of invasive disease in the United States, substantially contributed to the observed cases of S. pneumoniae-positive CAP or HCAP.

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Available from: Ronika Alexander, Aug 18, 2015
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    • "When Bewick et al. [93] evaluated the pneumococcal serotype distribution among patients with non-invasive CAP in the U.K.; PCV13-associated serotypes were identified in 57.4% of the cases. When Sherwin et al. [96] estimated the serotype distribution of pneumococcal pneumonia using serotype-specific UAD in U.S. adults aged ≥ 50 years; PCV13-associated serotypes were detected in 80% of patients with S. pneumoniae-positive CAP or healthcare-associated pneumonia. However, since the aforementioned UAD assays were developed by vaccine companies to study the efficacy of conjugate vaccine against pneumonia, the current UAD assays cover only a limited number of serotypes (13-14 serotypes) and are not commercially available. "
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