The burden of PCV13 serotypes in hospitalized pneumococcal pneumonia in Spain using a novel urinary antigen detection...

Area of Science:

• Infectious Diseases
• Epidemiology
• Vaccinology

Background:

• The distribution of Streptococcus pneumoniae serotypes causing community-acquired pneumonia (CAP) in hospitalized adults post-PCV13 introduction in children remains unclear.
• This study aimed to assess pneumococcal pneumonia serotype distribution in adults, considering risk factors and comorbidities after 2010.

Purpose of the Study:

• To evaluate the serotype distribution of pneumococcal pneumonia in hospitalized adults.
• To analyze serotype distribution based on risk factors and comorbidities.
• To assess changes after the introduction of PCV13 in the pediatric population.

Main Methods:

• Prospective study conducted from 2011-2014 in 3 Spanish hospitals involving immunocompetent adults hospitalized with CAP.
• Microbiological confirmation using serotype-specific urinary antigen detection tests (UAD) and conventional cultures.
• Enrollment of 1258 adults.

Main Results:

• Pneumococcal pneumonia was confirmed in 368 adults (29.3%).
• PCV13 serotypes caused 17.6% of all-cause CAP (3.5% PCV7 serotypes). Approximately 60% of pneumococcal CAP cases were due to PCV13 serotypes.
• Invasive disease episodes showed a higher prevalence of PCV13 serotypes (74.6%) compared to non-invasive ones (57.4%). Serotypes 1, 3, 7F, 19A, and 14 were most prevalent in invasive disease. No significant changes in PCV13 serotype distribution were observed over the study period.

Conclusions:

• PCV13 serotypes significantly contribute to CAP in both healthy and comorbid adults, with no decrease observed from 2011-2014.
• The findings suggest insufficient indirect protection from childhood PCV13 vaccination in adults.
• Implementing adult pneumococcal vaccination strategies is recommended to decrease the incidence of pneumococcal pneumonia.