Pneumococcal serotypes and risk factors in adult community-acquired pneumonia 2018-20; a multicentre UK cohort study
© 2023 The Authors..
Background: Higher-valency pneumococcal vaccines are anticipated. We aimed to describe serotype distribution and risk factors for vaccine-serotype community-acquired pneumonia (CAP) in the two years pre-SARS-CoV-2 pandemic.
Methods: We conducted a prospective cohort study of adults hospitalised with CAP at three UK sites between 2018 and 2020. Pneumococcal serotypes were identified using a 24-valent urinary-antigen assay and blood cultures. Risk factors associated with vaccine-type pneumonia caused by serotypes in the 13-, 15- and 20-valent pneumococcal conjugate vaccines (PCV13, PCV15, PCV20) and 23-valent pneumococcal polysaccharide vaccine (PPV23) were determined from multivariable analysis.
Findings: Of 1921 adults hospitalised with CAP, 781 (40.7%, 95% confidence intervals (CI) 38.5-42.9%) had pneumococcal pneumonia. A single PCV13-serotype was detected in 242 (31.0%, 95% CI 27.8-34.3%) pneumococcal CAP patients, mostly serotype 3 (171/242, 70.7%, 95% CI 64.5-76.0%). The additional two PCV15-serotypes were detected in 31 patients (4%, 95% CI 2.8-5.6%), and PCV20-non13-serotypes in 192 (24.6%), with serotype 8 most prevalent (123/192, 64.1%, 95% CI 57.1-70.5%). Compared to PCV13-serotype CAP, people with PCV20-non13 CAP were younger (median age 62 versus 72 years, p < 0.001) and less likely to be male (44% versus 61%, p = 0.01). PPV23-non13-serotypes were found in 252 (32.3%, 95% CI 29.1-35.6%) pneumococcal CAP patients.
Interpretation: Despite mature infant pneumococcal programmes, the burden of PCV13-serotype pneumonia remains high in older adults, mainly due to serotype 3. PCV20-non13-serotype pneumonia is more likely in younger people with fewer pneumococcal risk factors.
Funding: Unrestricted investigator-initiated research grant from Pfizer, United Kingdom; support from National Institute for Health Research (NIHR) Biomedical Research Centre, Nottingham.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
|---|---|
| Enthalten in: |
The Lancet regional health. Europe - 37(2024) vom: 08. Jan., Seite 100812 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Lansbury, Louise [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Journal Article |
|---|
| Anmerkungen: |
Date Revised 05.01.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1016/j.lanepe.2023.100812 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM366607677 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM366607677 | ||
| 003 | DE-627 | ||
| 005 | 20240108142303.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240108s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.lanepe.2023.100812 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1249.xml |
| 035 | |a (DE-627)NLM366607677 | ||
| 035 | |a (NLM)38170136 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Lansbury, Louise |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Pneumococcal serotypes and risk factors in adult community-acquired pneumonia 2018-20; a multicentre UK cohort study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 05.01.2024 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2023 The Authors. | ||
| 520 | |a Background: Higher-valency pneumococcal vaccines are anticipated. We aimed to describe serotype distribution and risk factors for vaccine-serotype community-acquired pneumonia (CAP) in the two years pre-SARS-CoV-2 pandemic | ||
| 520 | |a Methods: We conducted a prospective cohort study of adults hospitalised with CAP at three UK sites between 2018 and 2020. Pneumococcal serotypes were identified using a 24-valent urinary-antigen assay and blood cultures. Risk factors associated with vaccine-type pneumonia caused by serotypes in the 13-, 15- and 20-valent pneumococcal conjugate vaccines (PCV13, PCV15, PCV20) and 23-valent pneumococcal polysaccharide vaccine (PPV23) were determined from multivariable analysis | ||
| 520 | |a Findings: Of 1921 adults hospitalised with CAP, 781 (40.7%, 95% confidence intervals (CI) 38.5-42.9%) had pneumococcal pneumonia. A single PCV13-serotype was detected in 242 (31.0%, 95% CI 27.8-34.3%) pneumococcal CAP patients, mostly serotype 3 (171/242, 70.7%, 95% CI 64.5-76.0%). The additional two PCV15-serotypes were detected in 31 patients (4%, 95% CI 2.8-5.6%), and PCV20-non13-serotypes in 192 (24.6%), with serotype 8 most prevalent (123/192, 64.1%, 95% CI 57.1-70.5%). Compared to PCV13-serotype CAP, people with PCV20-non13 CAP were younger (median age 62 versus 72 years, p < 0.001) and less likely to be male (44% versus 61%, p = 0.01). PPV23-non13-serotypes were found in 252 (32.3%, 95% CI 29.1-35.6%) pneumococcal CAP patients | ||
| 520 | |a Interpretation: Despite mature infant pneumococcal programmes, the burden of PCV13-serotype pneumonia remains high in older adults, mainly due to serotype 3. PCV20-non13-serotype pneumonia is more likely in younger people with fewer pneumococcal risk factors | ||
| 520 | |a Funding: Unrestricted investigator-initiated research grant from Pfizer, United Kingdom; support from National Institute for Health Research (NIHR) Biomedical Research Centre, Nottingham | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Pneumococcal vaccines | |
| 650 | 4 | |a Pneumonia | |
| 650 | 4 | |a Risk factors | |
| 650 | 4 | |a Serogroup | |
| 650 | 4 | |a Streptococcus pneumoniae | |
| 700 | 1 | |a Lawrence, Hannah |e verfasserin |4 aut | |
| 700 | 1 | |a McKeever, Tricia M |e verfasserin |4 aut | |
| 700 | 1 | |a French, Neil |e verfasserin |4 aut | |
| 700 | 1 | |a Aston, Stephen |e verfasserin |4 aut | |
| 700 | 1 | |a Hill, Adam T |e verfasserin |4 aut | |
| 700 | 1 | |a Pick, Harry |e verfasserin |4 aut | |
| 700 | 1 | |a Baskaran, Vadsala |e verfasserin |4 aut | |
| 700 | 1 | |a Edwards-Pritchard, Rochelle C |e verfasserin |4 aut | |
| 700 | 1 | |a Bendall, Lesley |e verfasserin |4 aut | |
| 700 | 1 | |a Ashton, Deborah |e verfasserin |4 aut | |
| 700 | 1 | |a Butler, Jo |e verfasserin |4 aut | |
| 700 | 1 | |a Daniel, Priya |e verfasserin |4 aut | |
| 700 | 1 | |a Bewick, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Rodrigo, Chamira |e verfasserin |4 aut | |
| 700 | 1 | |a Litt, David |e verfasserin |4 aut | |
| 700 | 1 | |a Eletu, Seyi |e verfasserin |4 aut | |
| 700 | 1 | |a Sheppard, Carmen L |e verfasserin |4 aut | |
| 700 | 1 | |a Fry, Norman K |e verfasserin |4 aut | |
| 700 | 1 | |a Ladhani, Shamez |e verfasserin |4 aut | |
| 700 | 1 | |a Trotter, Caroline |e verfasserin |4 aut | |
| 700 | 1 | |a Lim, Wei Shen |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Lancet regional health. Europe |d 2021 |g 37(2024) vom: 08. Jan., Seite 100812 |w (DE-627)NLM323979734 |x 2666-7762 |7 nnns |
| 773 | 1 | 8 | |g volume:37 |g year:2024 |g day:08 |g month:01 |g pages:100812 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.lanepe.2023.100812 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 37 |j 2024 |b 08 |c 01 |h 100812 | ||