Expanded Analysis of 20 Pneumococcal Serotypes Associated With Radiographically Confirmed Community-acquired Pneumonia in Hospitalized US Adults

Abstract

Background Streptococcus pneumoniae is a causative agent of community-acquired pneumonia (CAP). The 13-valent pneumococcal conjugate vaccine (PCV13) has significantly decreased the burden of PCV13-serotype pneumococcal disease; however, disease due to nonvaccine serotypes remains substantial. A recent study documented the persistence of PCV13 serotypes among US adults hospitalized with radiographically confirmed CAP. The current analysis used a recently developed urinary antigen detection (UAD) assay (UAD2) to extend these results to additional serotypes included in an investigational PCV20 vaccine. Methods This prospective study enrolled adults aged ≥18 years hospitalized with radiographically confirmed CAP between October 2013–September 2016. Presence of S pneumoniae was determined by blood and respiratory sample culture, BinaxNOW® urine testing, and UAD. In addition to Quellung on cultured isolates when available, serotypes were identified from urine specimens using UAD1 for PCV13 serotypes and UAD2 for 7 PCV20-unique serotypes (8, 10A, 11A, 12F, 15B, 22F, and 33F) and 4 additional serotypes (2, 9N, 17F, and 20). Results Among 12,055 subjects with radiographically confirmed CAP, 1482 were positive for S pneumoniae. PCV13 and PCV20-unique serotypes were associated with 37.7% (n=559) and 27.0% (n=400) of cases, respectively; 288 subjects were exclusively diagnosed as positive for S pneumoniae by UAD2. Demographic and clinical disease characteristics were similar between subjects with CAP caused by PCV13 and PCV20-unique serotypes. Conclusions The current analysis using UAD2 identified a sizeable proportion of hospitalized adult CAP associated with PCV20-unique serotypes. PCV20 may therefore address the burden of CAP caused by the additional serotypes present in the vaccine.

Invasive Pneumococcal Disease Characterization in Adults and Subgroups aged < 60 years and ≥ 60 years in Bogota, Colombia

“…Consistent with the results of other studies, our study found that roughly half of hospitalized patients were younger than 60 years ( LeBlanc et al., 2017 ; Lopardo et al., 2018 ; Marrie et al., 2018 ; Isturiz et al., 2021 ). Interestingly, approximately 80% of IPD cases in adults aged 18-59 years in our study had ≥ 1 risk factor(s) for pneumococcal disease.…”

“…Although IPD is a public health problem of global interest, most pneumococcal epidemiology, serotype distribution, and disease burden data in adults are from high income countries in Europe and North America ( Weycker et al., 2016 ; LeBlanc et al., 2017 ; Micek et al., 2020 ; Amin-Chowdhury et al., 2021 ; Isturiz et al., 2021 ). These findings could differ from low- and middle-income countries, and well-characterized data for adults is required ( Deloria et al., 2021 ).…”

Use of 15-Valent Pneumococcal Conjugate Vaccine and 20-Valent Pneumococcal Conjugate Vaccine Among U.S. Adults: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2022

“…Annual incidence among U.S. adults aged <65 and ≥65 years hospitalized with community-acquired pneumonia was estimated at 126-422 and 847-3,365 per 100,000, respectively, during 2010-2016 (10). In a multisite study of adults hospitalized with community-acquired pneumonia, 4.6% of cases were caused by PCV13 serotypes, and 1.4% and 3.3% were caused by additional serotypes included in PCV15 and PCV20, respectively (11). *** Serotypes 22F and 33F, in addition to PCV13 serotypes.…”

Investigating the Effect of Pride, Mindfulness, General Self-Awareness, Emotional Satisfaction on Customer Citizenship Behavior Among Green Customers

“…Pride, as a self-centered emotion, is closely related to a person's inner state and characteristics, reinforcing positive emotions and differentiation. It is consistent with the individual's knowledge, expressions, and experiences (Isturiz, 2021). Pride increases awareness because it emphasizes individual differentiation through social comparison (Pfattheicher, 2015).…”