Pneumococcal epidemiology among us adults hospitalized for community-acquired pneumonia

Raul E. Isturiz; Julio Ramirez; Wesley H. Self; Carlos G. Grijalva; Francis L. Counselman; Gregory Volturo; Luis Ostrosky-Zeichner; Paula Peyrani; Richard G. Wunderink; Robert Sherwin; J. Scott Overcash; Senen Pena Oliva; Thomas File; Timothy L. Wiemken; John M. McLaughlin; Michael W. Pride; Sharon Gray; Ronika Alexander; Kimbal D. Ford; Qin Jiang; Luis Jodar

doi:10.1016/j.vaccine.2019.04.087

Pneumococcal epidemiology among us adults hospitalized for community-acquired pneumonia

Raul E. Isturiz, Julio Ramirez, Wesley H. Self, Carlos G. Grijalva, Francis L. Counselman, Gregory Volturo, Luis Ostrosky-Zeichner, Paula Peyrani, Richard G. Wunderink, Robert Sherwin, J. Scott Overcash, Senen Pena Oliva, Thomas File, Timothy L. Wiemken, John M. McLaughlin, Michael W. Pride, Sharon Gray, Ronika Alexander, Kimbal D. Ford, Qin JiangLuis Jodar

Medicine, Pulmonary Division

Research output: Contribution to journal › Article › peer-review

66 Scopus citations

Abstract

Background: Few studies have measured the burden of adult pneumococcal disease after the introduction of 13-valent pneumococcal conjugate vaccine (PCV13)into the US infant vaccination schedule. Further, most data regarding pneumococcal serotypes are derived from invasive pneumococcal disease (IPD), which represents only a fraction of all adult pneumococcal disease burden. Understanding which pneumococcal serotypes cause pneumonia in adults is critical for informing current immunization policy. The objective of this study was to measure the proportion of radiographically-confirmed (CXR+)community-acquired pneumonia (CAP)caused by PCV13 serotypes in hospitalized US adults. Methods: This observational, prospective surveillance study recruited hospitalized adults aged ≥18 years from 21 acute care hospitals across 10 geographically-dispersed cities in the United States between October 2013 and September 2016. Clinical and demographic data were collected during hospitalization. Vital status was ascertained 30 days after enrollment. Pneumococcal serotypes were detected via culture from the respiratory tract and normally-sterile sites (including blood and pleural fluid). Additionally, a novel, Luminex-based serotype-specific urinary antigen detection (UAD)assay was used to detect serotypes included in PCV13. Results: Of 15,572 enrolled participants, 12,055 eligible patients with CXR+CAP were included in the final analysis population. Mean age was 64.1 years and 52.7% were aged ≥65 years. Common comorbidities included chronic obstructive pulmonary disease (43.0%)and diabetes mellitus (28.6%). PCV13 serotypes were detected in 552/12,055 (4.6%)of all patients and 265/6347 (4.2%)of those aged ≥65 years. Among patients aged 18–64 years PCV13 serotypes were detected in 3.8–5.3% of patients depending on their risk status. Conclusions: After implementation of a pneumococcal conjugate vaccination program in US children, and despite the herd protection observed in US adults, a persistent burden of PCV13-type CAP remains in this population.

Original language	English (US)
Pages (from-to)	3352-3361
Number of pages	10
Journal	Vaccine
Volume	37
Issue number	25
DOIs	https://doi.org/10.1016/j.vaccine.2019.04.087
State	Published - May 31 2019

Funding

This study was sponsored by Pfizer, Inc. Editorial assistance was provided by Scott Vuocolo, PhD (Pfizer, Inc.). This study was sponsored by Pfizer, Inc .

Keywords

Community
Pneumococcus
Pneumonia
Streptococcus

ASJC Scopus subject areas

Molecular Medicine
General Immunology and Microbiology
General Veterinary
Public Health, Environmental and Occupational Health
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.vaccine.2019.04.087

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Isturiz, R. E., Ramirez, J., Self, W. H., Grijalva, C. G., Counselman, F. L., Volturo, G., Ostrosky-Zeichner, L., Peyrani, P., Wunderink, R. G., Sherwin, R., Overcash, J. S., Oliva, S. P., File, T., Wiemken, T. L., McLaughlin, J. M., Pride, M. W., Gray, S., Alexander, R., Ford, K. D., ... Jodar, L. (2019). Pneumococcal epidemiology among us adults hospitalized for community-acquired pneumonia. Vaccine, 37(25), 3352-3361. https://doi.org/10.1016/j.vaccine.2019.04.087

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title = "Pneumococcal epidemiology among us adults hospitalized for community-acquired pneumonia",

abstract = "Background: Few studies have measured the burden of adult pneumococcal disease after the introduction of 13-valent pneumococcal conjugate vaccine (PCV13)into the US infant vaccination schedule. Further, most data regarding pneumococcal serotypes are derived from invasive pneumococcal disease (IPD), which represents only a fraction of all adult pneumococcal disease burden. Understanding which pneumococcal serotypes cause pneumonia in adults is critical for informing current immunization policy. The objective of this study was to measure the proportion of radiographically-confirmed (CXR+)community-acquired pneumonia (CAP)caused by PCV13 serotypes in hospitalized US adults. Methods: This observational, prospective surveillance study recruited hospitalized adults aged ≥18 years from 21 acute care hospitals across 10 geographically-dispersed cities in the United States between October 2013 and September 2016. Clinical and demographic data were collected during hospitalization. Vital status was ascertained 30 days after enrollment. Pneumococcal serotypes were detected via culture from the respiratory tract and normally-sterile sites (including blood and pleural fluid). Additionally, a novel, Luminex-based serotype-specific urinary antigen detection (UAD)assay was used to detect serotypes included in PCV13. Results: Of 15,572 enrolled participants, 12,055 eligible patients with CXR+CAP were included in the final analysis population. Mean age was 64.1 years and 52.7% were aged ≥65 years. Common comorbidities included chronic obstructive pulmonary disease (43.0%)and diabetes mellitus (28.6%). PCV13 serotypes were detected in 552/12,055 (4.6%)of all patients and 265/6347 (4.2%)of those aged ≥65 years. Among patients aged 18–64 years PCV13 serotypes were detected in 3.8–5.3% of patients depending on their risk status. Conclusions: After implementation of a pneumococcal conjugate vaccination program in US children, and despite the herd protection observed in US adults, a persistent burden of PCV13-type CAP remains in this population.",

keywords = "Community, Pneumococcus, Pneumonia, Streptococcus",

author = "Isturiz, {Raul E.} and Julio Ramirez and Self, {Wesley H.} and Grijalva, {Carlos G.} and Counselman, {Francis L.} and Gregory Volturo and Luis Ostrosky-Zeichner and Paula Peyrani and Wunderink, {Richard G.} and Robert Sherwin and Overcash, {J. Scott} and Oliva, {Senen Pena} and Thomas File and Wiemken, {Timothy L.} and McLaughlin, {John M.} and Pride, {Michael W.} and Sharon Gray and Ronika Alexander and Ford, {Kimbal D.} and Qin Jiang and Luis Jodar",

note = "Publisher Copyright: {\textcopyright} 2019 The Author(s)",

year = "2019",

month = may,

day = "31",

doi = "10.1016/j.vaccine.2019.04.087",

language = "English (US)",

volume = "37",

pages = "3352--3361",

journal = "Vaccine",

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Isturiz, RE, Ramirez, J, Self, WH, Grijalva, CG, Counselman, FL, Volturo, G, Ostrosky-Zeichner, L, Peyrani, P, Wunderink, RG, Sherwin, R, Overcash, JS, Oliva, SP, File, T, Wiemken, TL, McLaughlin, JM, Pride, MW, Gray, S, Alexander, R, Ford, KD, Jiang, Q & Jodar, L 2019, 'Pneumococcal epidemiology among us adults hospitalized for community-acquired pneumonia', Vaccine, vol. 37, no. 25, pp. 3352-3361. https://doi.org/10.1016/j.vaccine.2019.04.087

TY - JOUR

T1 - Pneumococcal epidemiology among us adults hospitalized for community-acquired pneumonia

AU - Isturiz, Raul E.

AU - Ramirez, Julio

AU - Self, Wesley H.

AU - Grijalva, Carlos G.

AU - Counselman, Francis L.

AU - Volturo, Gregory

AU - Ostrosky-Zeichner, Luis

AU - Peyrani, Paula

AU - Wunderink, Richard G.

AU - Sherwin, Robert

AU - Overcash, J. Scott

AU - Oliva, Senen Pena

AU - File, Thomas

AU - Wiemken, Timothy L.

AU - McLaughlin, John M.

AU - Pride, Michael W.

AU - Gray, Sharon

AU - Alexander, Ronika

AU - Ford, Kimbal D.

AU - Jiang, Qin

AU - Jodar, Luis

PY - 2019/5/31

Y1 - 2019/5/31

N2 - Background: Few studies have measured the burden of adult pneumococcal disease after the introduction of 13-valent pneumococcal conjugate vaccine (PCV13)into the US infant vaccination schedule. Further, most data regarding pneumococcal serotypes are derived from invasive pneumococcal disease (IPD), which represents only a fraction of all adult pneumococcal disease burden. Understanding which pneumococcal serotypes cause pneumonia in adults is critical for informing current immunization policy. The objective of this study was to measure the proportion of radiographically-confirmed (CXR+)community-acquired pneumonia (CAP)caused by PCV13 serotypes in hospitalized US adults. Methods: This observational, prospective surveillance study recruited hospitalized adults aged ≥18 years from 21 acute care hospitals across 10 geographically-dispersed cities in the United States between October 2013 and September 2016. Clinical and demographic data were collected during hospitalization. Vital status was ascertained 30 days after enrollment. Pneumococcal serotypes were detected via culture from the respiratory tract and normally-sterile sites (including blood and pleural fluid). Additionally, a novel, Luminex-based serotype-specific urinary antigen detection (UAD)assay was used to detect serotypes included in PCV13. Results: Of 15,572 enrolled participants, 12,055 eligible patients with CXR+CAP were included in the final analysis population. Mean age was 64.1 years and 52.7% were aged ≥65 years. Common comorbidities included chronic obstructive pulmonary disease (43.0%)and diabetes mellitus (28.6%). PCV13 serotypes were detected in 552/12,055 (4.6%)of all patients and 265/6347 (4.2%)of those aged ≥65 years. Among patients aged 18–64 years PCV13 serotypes were detected in 3.8–5.3% of patients depending on their risk status. Conclusions: After implementation of a pneumococcal conjugate vaccination program in US children, and despite the herd protection observed in US adults, a persistent burden of PCV13-type CAP remains in this population.

AB - Background: Few studies have measured the burden of adult pneumococcal disease after the introduction of 13-valent pneumococcal conjugate vaccine (PCV13)into the US infant vaccination schedule. Further, most data regarding pneumococcal serotypes are derived from invasive pneumococcal disease (IPD), which represents only a fraction of all adult pneumococcal disease burden. Understanding which pneumococcal serotypes cause pneumonia in adults is critical for informing current immunization policy. The objective of this study was to measure the proportion of radiographically-confirmed (CXR+)community-acquired pneumonia (CAP)caused by PCV13 serotypes in hospitalized US adults. Methods: This observational, prospective surveillance study recruited hospitalized adults aged ≥18 years from 21 acute care hospitals across 10 geographically-dispersed cities in the United States between October 2013 and September 2016. Clinical and demographic data were collected during hospitalization. Vital status was ascertained 30 days after enrollment. Pneumococcal serotypes were detected via culture from the respiratory tract and normally-sterile sites (including blood and pleural fluid). Additionally, a novel, Luminex-based serotype-specific urinary antigen detection (UAD)assay was used to detect serotypes included in PCV13. Results: Of 15,572 enrolled participants, 12,055 eligible patients with CXR+CAP were included in the final analysis population. Mean age was 64.1 years and 52.7% were aged ≥65 years. Common comorbidities included chronic obstructive pulmonary disease (43.0%)and diabetes mellitus (28.6%). PCV13 serotypes were detected in 552/12,055 (4.6%)of all patients and 265/6347 (4.2%)of those aged ≥65 years. Among patients aged 18–64 years PCV13 serotypes were detected in 3.8–5.3% of patients depending on their risk status. Conclusions: After implementation of a pneumococcal conjugate vaccination program in US children, and despite the herd protection observed in US adults, a persistent burden of PCV13-type CAP remains in this population.

KW - Community

KW - Pneumococcus

KW - Pneumonia

KW - Streptococcus

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JO - Vaccine

JF - Vaccine

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ER -

Pneumococcal epidemiology among us adults hospitalized for community-acquired pneumonia

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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