Surveillance of invasive pneumococcal disease (IPD) is important to understand the effects of direct and indirect protection from pneumococcal vaccination programs and inform vaccine development and policy.
As part of the ongoing Pneumococcal Pneumonia Epidemiology, Urine Serotyping, and Mental Outcomes (PNEUMO) study, we enrolled adults hospitalized with IPD in Nashville and Atlanta from September-2018 to August-2019. IPD was defined by isolation of Streptococcus pneumoniae from a normally-sterile site.
We enrolled 25 IPD cases, including 18 (72%) pneumonia, 5 (20%) bacteremia without an identified focus, 1 meningitis, and 1 septic arthritis. Pneumococcal serotype was identified from blood culture in 20 cases, including serotypes: 35B–(3 cases), 3-(2 cases), 15A-(2 cases), 19F-(2 cases), 20-(2 cases), 23A-(2 cases), 22F, 8, 9N, 11A, 23B, 31, 35F. Median age was 62 years; 23 (92%) presented from a community residence; 12 (48%) were immunocompromised; and all had ≥1 major chronic medical condition. In-hospital outcomes: 0 deaths; 10 (40%) ICU admissions; 9 (36%) mechanical ventilation; 3 (12%) vasopressors; 3 (12%) pleural drainage procedure; 1 (4%) new renal-replacement-therapy.
IPD is a highly morbid disease in US adults, with most cases in this study caused by serotypes not in the current 13-valent pneumococcal conjugate vaccine.