Serotype Distribution in Non-Bacteremic Pneumococcal Pneumonia: Association with Disease Severity and Implications for Pneumococcal Conjugate Vaccines

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Benfield, Thomas ; Skovgaard, Marlene ; Schønheyder, Henrik Carl ; Knudsen, Jenny Dahl ; Bangsborg, Jette ; Østergaard, Christian ; Slotved, Hans-Christian ; Konradsen, Helle Bossen ; Thomsen, Reimar Wernich ; Lambertsen, Lotte
• Description:
  Background
  
  There is limited knowledge of serotypes that cause non-bacteremic pneumococcal pneumonia (NBP). Here we report serotypes, their associated disease potential and coverage of pneumococcal conjugate vaccines (PCV) in adults with NBP and compare these to bacteremic pneumonia (BP).
  
  Methods
  
  Adults with pneumonia and Streptococcus pneumoniae isolated from the lower respiratory tract or blood were included 1 year in a population-based design in Denmark. Pneumonia was defined as a new infiltrate on chest radiograph in combination with clinical symptoms or elevated white blood count or plasma C-reactive protein. All isolates were serotyped using type-specific pneumococcal rabbit antisera. All values are medians with interquartile ranges.
  
  Results
  
  There were 272 cases of NBP and 192 cases of BP. Ninety-nine percent were hospitalized. NBP and BP cases were of comparable age and sex but NBP cases had more respiratory symptoms and less severe disease compared to BP cases. In total, 46 different serotypes were identified. Among NBP cases, 5 serotypes accounted for nearly a third of isolates. PCV10 and -13 types covered 17% (95% confidence interval (CI): 11-23%) and 34% (95% CI: 25-43%) of NBP isolates, respectively. In contrast, the five most frequent serotypes accounted for two-thirds of BP isolates. PCV10 and -13 types covered 39% (95% CI: 30-48%) and 64% (95% CI: 48-79) of BP isolates, respectively. More severe NBP disease was associated with infection with invasive serotypes while there was an inverse relationship for BP.
  
  Conclusions
  
  Only a third of cases of adult non-bacteremic pneumococcal pneumonia would potentially be preventable with the use of PCV13 and just one sixth of cases with the use of PCV10 indicating that PCVs with increased valency are needed to increase vaccine coverage for NBP in adults. PCV13 could potentially prevent two-thirds of adult bacteremic pneumococcal pneumonia.
  
  
• Subjects:
  Adolescent Adult Aged Aged, 80 And Over Age Factors Female Humans Male Middle Aged Pneumococcal Vaccines Pneumonia, Pneumococcal Serotyping Severity Of Illness Index Streptococcus Pneumoniae Vaccines, Conjugate Young Adult

  More +
• Source:
  PLoS One. 2013; 8(8).
• Document Type:
  Journal Article
• Place as Subject:
  Denmark
• Volume:
  8
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:1b539a5392cbac9fbb1671b4819c6eca1e5209e4ca1b30c1ceb3ccb949da9eab
• Download URL:
  https://stacks.cdc.gov/view/cdc/21117/cdc_21117_DS1.pdf
• File Type:
  [PDF - 232.33 KB ]