Elisabeth Rünow,

Poster Author Of 1 e-Poster

Author Of 1 Presentation

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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