Qin Jiang, United States of America

Pfizer Inc Vaccine Research & Development

Poster Author Of 1 e-Poster

Author Of 2 Presentations

STREPTOCOCCUS PNEUMONIAE SEROTYPE DISTRIBUTION AND COVERAGE OF PNEUMOCOCCAL CONJUGATE VACCINES IN ADULTS HOSPITALIZED WITH COMMUNITY-ACQUIRED PNEUMONIA IN THE UNITED STATES (ID 879)

Abstract

Background

The study objective was to determine the prevalence of serotypes and coverage provided by currently licensed and next generation pneumococcal conjugate vaccines (PCVs) in adults hospitalized with community-acquired pneumonia (CAP) in the United States.

Methods

Hospitalized adults aged ≥18 years with radiologically-confirmed (CXR+) CAP were enrolled from 10 U.S. cities between October 2013 and September 2016. S. pneumoniae isolates cultured from normally-sterile standard-of-care specimens were serotyped by Quellung. Urine was tested using BinaxNOW® and a serotype-specific urine antigen detection (UAD) assay that detects serotypes contained in PCV13 plus 6C (highly-related to 6A), PCV15 (PCV13 serotypes, 22F, and 33F), PCV20 (PCV15 serotypes, 8, 10A, 11A, 12F, and 15B plus 15C (highly-related to 15B)), and non-PCV serotypes 2, 9N, 17F, and 20. Coverage was calculated as the percent of CXR+CAP participants positive for a serotype in PCV13, PCV15, and PCV20.

Results

Of 15,572 enrolled participants, 12,055 with CXR+CAP were included in the analysis; 52.7% (n=6347) were ≥65 years. Coverage of CXR+CAP varied by PCV formulation (Table). About 1% of CXR+CAP was due to serotypes 2, 9N, 17F, and 20 combined.

b1851147_uad2 isppd2020 table_2020.0108.docx.png

Conclusions

Compared to PCV13, PCV20 increased coverage of CXR+CAP due to PCV serotypes by 71% (18-64 years) and 64% (≥65 years).

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PNEUMOCOCCAL SEROTYPE DISTRIBUTION IN ADULTS HOSPITALIZED WITH RADIOLOGICALLY-CONFIRMED COMMUNITY-ACQUIRED PNEUMONIA IN MALMÖ, SWEDEN (ID 904)

Abstract

Background

In Sweden, pneumococcal serotype distribution in adults with community-acquired pneumonia (CAP) and potential coverage of licensed and developmental pneumococcal conjugate vaccines (PCVs) are unknown.

Methods

2016-2018, consecutive patients aged ≥18 years hospitalized with chest x-ray positive (CXR+) CAP were enrolled at Skåne University Hospital. Streptococcus pneumoniae (Spn) blood culture isolates were serotyped by multiprime PCR and Quellung reaction. Urine was tested by the pan-pneumococcal urinary antigen test (BinaxNOW®) and Pfizer’s proprietary serotype-specific urine antigen detection assays (UAD1/UAD2). UAD1 detects serotypes in PCV13, UAD2 detects additional serotypes in PCV15 and PCV20 plus serotypes 2,9N,17F and 20.

Results

Of 567 enrollees, 518 had CXR+CAP and urine sample collected and were included in analysis. Spn serotypes were identified by UAD or blood culture isolates.

Table CXR+CAP by age group and vaccine serotype categories.

Spn detected:

18-64 years
n=169 (32.6%)

≥65 years
n=349 (67.4%)

≥18 years
n=518 (100%)

PCV13-types*

12.4%

10.0%

10.8%

PCV15-types*

13.6%

12.0%

12.5%

PCV20-types*

20.7%

15.2%

17.0%

Any Spn

27.2%

22.9%

24.3%

*PCV13:1,3,4,5,6A/6C,6B,7F,9V,14,18C,19A,19F,23F

PCV15:PCV13+22F,33F

PCV20:PCV15+8,10A,11A,12F,15B/C

Conclusions

In the context of robust pediatric PCV immunization, PCV13 serotypes were relatively common in adult CXR+CAP, emphasizing the limits of relying on indirect protection. PCV20 will further increase the ability of direct vaccination to reduce adult pneumonia morbidity.

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