Qin Jiang, United States of America
Pfizer Inc Vaccine Research & DevelopmentPoster Author Of 1 e-Poster
PNEUMOCOCCAL SEROTYPE DISTRIBUTION IN ADULTS HOSPITALIZED WITH RADIOLOGICALLY-CONFIRMED COMMUNITY-ACQUIRED PNEUMONIA IN MALMÖ, SWEDEN
Author Of 2 Presentations
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 | ≥65 years | ≥18 years |
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.
STREPTOCOCCUS PNEUMONIAE SEROTYPE DISTRIBUTION AND COVERAGE OF PNEUMOCOCCAL CONJUGATE VACCINES IN ADULTS HOSPITALIZED WITH COMMUNITY-ACQUIRED PNEUMONIA IN THE UNITED STATES (ID 879)
- Lindsay R. Grant, United States of America
- Julio Ramirez, United States of America
- Wesley H. Self, United States of America
- Francis Counselman, United States of America
- Gregory Volturo, United States of America
- Luis Ostrosky-Zeichner, United States of America
- Paula Peyrani, United States of America
- Richard Wunderink, United States of America
- Robert Sherwin, United States of America
- J. Scott Overcash, United States of America
- Thomas File, United States of America
- Michael W. Pride, United States of America
- Sharon L. Gray, United States of America
- Ronika Alexander, United States of America
- Kimbal D. Ford, United States of America
- Qin Jiang, United States of America
- Luis Jodar, United States of America
- Raul Isturiz, United States of America
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.
Conclusions
Compared to PCV13, PCV20 increased coverage of CXR+CAP due to PCV serotypes by 71% (18-64 years) and 64% (≥65 years).