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Radiographically confirmed community-acquired pneumonia in hospitalized adults due to pneumococcal vaccine serotypes in Sweden, 2016–2018—The ECAPS study

Hansen, Karin LU ; Rünow, Elisabeth LU orcid ; Torisson, Gustav LU orcid ; Theilacker, Christian ; Palmborg, Andreas ; Pan, Kaijie ; Jiang, Qin ; Southern, Jo ; Beavon, Rohini and Gessner, Bradford D. , et al. (2023) In Frontiers in Public Health 11.
Abstract

Objectives: In Sweden, pneumococcal serotype distribution in adults with community-acquired pneumonia (CAP) and potential coverage of currently licensed pneumococcal conjugate vaccines (PCVs) is unknown. Methods: During 2016–2018, patients aged ≥18 years hospitalized with radiologically confirmed (RAD+) CAP were enrolled at Skåne University Hospital in a study on the etiology of CAP in Sweden (ECAPS). Urine samples and blood cultures were collected per-protocol. Streptococcus pneumoniae (Spn) culture isolates were serotyped and urine samples tested for the pan-pneumococcal urinary antigen (PUAT) and multiplex urine antigen detection (UAD) assay, detecting 24 serotypes. Results: Analyses included 518 participants with RAD+CAP; 67.4% were... (More)

Objectives: In Sweden, pneumococcal serotype distribution in adults with community-acquired pneumonia (CAP) and potential coverage of currently licensed pneumococcal conjugate vaccines (PCVs) is unknown. Methods: During 2016–2018, patients aged ≥18 years hospitalized with radiologically confirmed (RAD+) CAP were enrolled at Skåne University Hospital in a study on the etiology of CAP in Sweden (ECAPS). Urine samples and blood cultures were collected per-protocol. Streptococcus pneumoniae (Spn) culture isolates were serotyped and urine samples tested for the pan-pneumococcal urinary antigen (PUAT) and multiplex urine antigen detection (UAD) assay, detecting 24 serotypes. Results: Analyses included 518 participants with RAD+CAP; 67.4% were ≥65 years of age, 73.4% were either immunocompromised or had an underlying chronic medical condition. The proportion of CAP due to Spn identified by any method was 24.3% of which 9.3% was detected by UAD alone. The most frequently identified serotypes were 3 (26 cases, 5.0% of all CAP), and 8, 11A and 19A (10 cases each, 1.9%). In individuals aged 18–64 and ≥65 years, respectively, PCV20 serotypes contributed to 35 of 169 (20.7%) and 53 of 349 cases of all CAP (15.2%), and PCV13 serotypes caused 21 of 169 (12.4%) and 35 of 349 (10.0%) cases. PCV15 coverage was 23 of 169 (13.6%) and 42 of 349 (12.0%) in individuals aged 18–64 and ≥65 years, respectively. Overall, PCV20 increases the coverage of all CAP from 10.8% (PCV13) to 17.0%. Conclusion: Compared to earlier pneumococcal vaccines, PCV20 expands the coverage of all-cause CAP. Routine diagnostic tests underestimate the proportion of CAP caused by Spn.

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organization
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type
Contribution to journal
publication status
published
subject
keywords
community-acquired pneumonia (CAP), pneumococcal conjugate vaccine, pneumococcal vaccination, Streptococcus pneumoniae, Sweden
in
Frontiers in Public Health
volume
11
article number
1086648
publisher
Frontiers Media S. A.
external identifiers
  • pmid:36875379
  • scopus:85149510218
ISSN
2296-2565
DOI
10.3389/fpubh.2023.1086648
language
English
LU publication?
yes
id
98eceed7-ad95-4d51-8957-e42cc49894ec
date added to LUP
2023-04-03 12:14:11
date last changed
2024-06-13 13:59:15
@article{98eceed7-ad95-4d51-8957-e42cc49894ec,
  abstract     = {{<p>Objectives: In Sweden, pneumococcal serotype distribution in adults with community-acquired pneumonia (CAP) and potential coverage of currently licensed pneumococcal conjugate vaccines (PCVs) is unknown. Methods: During 2016–2018, patients aged ≥18 years hospitalized with radiologically confirmed (RAD+) CAP were enrolled at Skåne University Hospital in a study on the etiology of CAP in Sweden (ECAPS). Urine samples and blood cultures were collected per-protocol. Streptococcus pneumoniae (Spn) culture isolates were serotyped and urine samples tested for the pan-pneumococcal urinary antigen (PUAT) and multiplex urine antigen detection (UAD) assay, detecting 24 serotypes. Results: Analyses included 518 participants with RAD+CAP; 67.4% were ≥65 years of age, 73.4% were either immunocompromised or had an underlying chronic medical condition. The proportion of CAP due to Spn identified by any method was 24.3% of which 9.3% was detected by UAD alone. The most frequently identified serotypes were 3 (26 cases, 5.0% of all CAP), and 8, 11A and 19A (10 cases each, 1.9%). In individuals aged 18–64 and ≥65 years, respectively, PCV20 serotypes contributed to 35 of 169 (20.7%) and 53 of 349 cases of all CAP (15.2%), and PCV13 serotypes caused 21 of 169 (12.4%) and 35 of 349 (10.0%) cases. PCV15 coverage was 23 of 169 (13.6%) and 42 of 349 (12.0%) in individuals aged 18–64 and ≥65 years, respectively. Overall, PCV20 increases the coverage of all CAP from 10.8% (PCV13) to 17.0%. Conclusion: Compared to earlier pneumococcal vaccines, PCV20 expands the coverage of all-cause CAP. Routine diagnostic tests underestimate the proportion of CAP caused by Spn.</p>}},
  author       = {{Hansen, Karin and Rünow, Elisabeth and Torisson, Gustav and Theilacker, Christian and Palmborg, Andreas and Pan, Kaijie and Jiang, Qin and Southern, Jo and Beavon, Rohini and Gessner, Bradford D. and Riesbeck, Kristian and Ahl, Jonas}},
  issn         = {{2296-2565}},
  keywords     = {{community-acquired pneumonia (CAP); pneumococcal conjugate vaccine; pneumococcal vaccination; Streptococcus pneumoniae; Sweden}},
  language     = {{eng}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Public Health}},
  title        = {{Radiographically confirmed community-acquired pneumonia in hospitalized adults due to pneumococcal vaccine serotypes in Sweden, 2016–2018—The ECAPS study}},
  url          = {{http://dx.doi.org/10.3389/fpubh.2023.1086648}},
  doi          = {{10.3389/fpubh.2023.1086648}},
  volume       = {{11}},
  year         = {{2023}},
}