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

• Published in: The Journal of infectious diseases Vol. 208; no. 11; pp. 1813 - 1820
• Main Authors: Sherwin, Robert L., Gray, Sharon, Alexander, Ronika, McGovern, Paul C., Graepel, Jay, Pride, Michael W., Purdy, Jay, Paradiso, Peter, File, Thomas M.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.12.2013
• Subjects: Adults; Aged; Aged, 80 and over; Applied microbiology; BACTERIA; Bacteriology; Biological and medical sciences; Community-Acquired Infections - epidemiology; Community-Acquired Infections - immunology; Community-Acquired Infections - microbiology; Community-Acquired Infections - prevention & control; Conjugate vaccines; Cross Infection; Cross-Sectional Studies; Demography; Diseases; Epidemiology; Female; Fundamental and applied biological sciences. Psychology; Hospitals; Humans; Infectious diseases; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Mortality; Pneumococcal Infections - epidemiology; Pneumococcal Infections - immunology; Pneumococcal Infections - microbiology; Pneumococcal Infections - prevention & control; Pneumococcal pneumonia; Pneumococcal Vaccines - immunology; Pneumonia; Polysaccharides; Prevalence; Prospective Studies; Serotyping; Species Specificity; Streptococcus pneumoniae; Streptococcus pneumoniae - classification; Streptococcus pneumoniae - immunology; United States - epidemiology; Urine; Vaccination; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects); Vaccines, Conjugate - immunology; Lung disease; Streptococcaceae; Pneumonia; Community acquired infection; Respiratory disease; Bacteria; Micrococcales; Vaccine; Serotype; Streptococcus pneumoniae; 13-valent pneumococcal conjugate vaccine; urinary antigen detection assay; healthcare-associated pneumonia; serotype distribution; community-acquired pneumonia; pneumococcal serotypes
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1093/infdis/jit506

Background. 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. Methods. 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. Results. 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 PCV 13-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. Conclusions. 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.