Wesley H. Self, United States of America
Vanderbilt University Medical Center Emergency MedicinePresenter of 2 Presentations
INCIDENCE OF PNEUMOCOCCAL AND ALL-CAUSE PNEUMONIA IN ADULTS IN TENNESSEE AND GEORGIA, USA, 2018-2019: RESULTS FROM THE PNEUMO STUDY (ID 350)
- Wesley H. Self, United States of America
- Nadine Rouphael, United States of America
- Kelly D. Johnson, United States of America
- Christopher J. Lindsell, United States of America
- Cynthia G. Whitney, United States of America
- Matthew Phillips, United States of America
- Jin H. Han, United States of America
- Laurel R. Bristow, United States of America
- Inci Yildirim, United States of America
- Evan Anderson, United States of America
- Laila Hussaini, United States of America
- Adrienne Baughman, United States of America
- Christopher Gray, United States of America
- Kimberly Hart, United States of America
- Wu Gong, United States of America
- Danielle Fayad, United States of America
- Andrew Cheng, United States of America
- Zayna Al-Husein, United States of America
- Lyn Finelli, United States of America
- Carlos Grijalva, United States of America
QUALITY OF LIFE FOLLOWING PNEUMOCOCCAL AND ALL-CAUSE PNEUMONIA: RESULTS FROM THE PNEUMO STUDY (ID 352)
- Wesley H. Self, United States of America
- Christopher J. Lindsell, United States of America
- Nadine Rouphael, United States of America
- Kelly D. Johnson, United States of America
- Cynthia G. Whitney, United States of America
- Matthew Phillips, United States of America
- Inci Yildirim, United States of America
- Laurel R. Bristow, United States of America
- Adrienne Baughman, United States of America
- Christopher Gray, United States of America
- Evan Anderson, United States of America
- Laila Hussaini, United States of America
- Kimberly Hart, United States of America
- Wu Gong, United States of America
- Lyn Finelli, United States of America
- Carlos Grijalva, United States of America
- Jin H. Han, United States of America
Author Of 5 Presentations
QUALITY OF LIFE FOLLOWING PNEUMOCOCCAL AND ALL-CAUSE PNEUMONIA: RESULTS FROM THE PNEUMO STUDY (ID 352)
- Wesley H. Self, United States of America
- Christopher J. Lindsell, United States of America
- Nadine Rouphael, United States of America
- Kelly D. Johnson, United States of America
- Cynthia G. Whitney, United States of America
- Matthew Phillips, United States of America
- Inci Yildirim, United States of America
- Laurel R. Bristow, United States of America
- Adrienne Baughman, United States of America
- Christopher Gray, United States of America
- Evan Anderson, United States of America
- Laila Hussaini, United States of America
- Kimberly Hart, United States of America
- Wu Gong, United States of America
- Lyn Finelli, United States of America
- Carlos Grijalva, United States of America
- Jin H. Han, United States of America
COGNITIVE FUNCTION FOLLOWING PNEUMOCOCCAL AND ALL-CAUSE PNEUMONIA: RESULTS FROM THE PNEUMO STUDY (ID 353)
- Jin H. Han, United States of America
- Christopher J. Lindsell, United States of America
- Nadine Rouphael, United States of America
- Kelly D. Johnson, United States of America
- Cynthia G. Whitney, United States of America
- Matthew Phillips, United States of America
- Inci Yildirim, United States of America
- Laurel R. Bristow, United States of America
- Adrienne Baughman, United States of America
- Christopher Gray, United States of America
- Evan Anderson, United States of America
- Laila Hussaini, United States of America
- Kimberly Hart, United States of America
- Wu Gong, United States of America
- Lyn Finelli, United States of America
- Carlos Grijalva, United States of America
- Wesley H. Self, United States of America
Abstract
Background
Systemic inflammation from pneumonia may lead to acute brain dysfunction and long-term cognitive impairment, especially in older patients with severe pneumonia.
Methods
As part of the ongoing Pneumococcal Pneumonia Epidemiology, Urine Serotyping, and Mental Outcomes (PNEUMO) study, we prospectively enrolled adults hospitalized with community-acquired pneumonia. We tested for Streptococcus pneumoniae with cultures and BinaxNOW urinary antigen tests. We assessed global cognition in patients ≥50 years old with the Montreal Cognitive Assessment-Blind Adaptation (MoCA-Blind). MoCA-Blind scores range from 0 to 22 with higher scores indicating better cognition. Adults with a MoCA-Blind score <18 are considered to have cognitive impairment. We administered the MoCA-Blind instrument at enrollment when the patient was acutely ill and 6-months later by phone.
Results
At the time of this interim analysis, 150 patients had cognitive assessments completed at enrollment and 6-months, including 12 (8.0%) with pneumococcal pneumonia. Median (IQR) age was 64 (58-71) years. Cognitive impairment was common at both enrollment and 6-months later (Figure). At 6-month follow-up, 58% of pneumococcal and 52% of non-pneumococcal pneumonia patients had a MoCA-Blind score <18.
Conclusions
Hospitalization for pneumonia, including pneumococcal pneumonia, is associated with high risk of acute and persistent cognitive impairment among US adults ≥50 years old.
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).
INCIDENCE OF PNEUMOCOCCAL AND ALL-CAUSE PNEUMONIA IN ADULTS IN TENNESSEE AND GEORGIA, USA, 2018-2019: RESULTS FROM THE PNEUMO STUDY (ID 350)
- Wesley H. Self, United States of America
- Nadine Rouphael, United States of America
- Kelly D. Johnson, United States of America
- Christopher J. Lindsell, United States of America
- Cynthia G. Whitney, United States of America
- Matthew Phillips, United States of America
- Jin H. Han, United States of America
- Laurel R. Bristow, United States of America
- Inci Yildirim, United States of America
- Evan Anderson, United States of America
- Laila Hussaini, United States of America
- Adrienne Baughman, United States of America
- Christopher Gray, United States of America
- Kimberly Hart, United States of America
- Wu Gong, United States of America
- Danielle Fayad, United States of America
- Andrew Cheng, United States of America
- Zayna Al-Husein, United States of America
- Lyn Finelli, United States of America
- Carlos Grijalva, United States of America
INVASIVE PNEUMOCOCCAL DISEASE IN ADULTS IN TENNESSEE AND GEORGIA, USA: RESULTS FROM THE PNEUMO STUDY (ID 351)
- Laurel R. Bristow, United States of America
- Cynthia G. Whitney, United States of America
- Wesley H. Self, United States of America
- Kelly D. Johnson, United States of America
- Christopher J. Lindsell, United States of America
- Matthew Phillips, United States of America
- Inci Yildirim, United States of America
- Jin H. Han, United States of America
- Adrienne Baughman, United States of America
- Christopher Gray, United States of America
- Evan Anderson, United States of America
- Laila Hussaini, United States of America
- Kimberly Hart, United States of America
- Wu Gong, United States of America
- Danielle Fayad, United States of America
- Andrew Cheng, United States of America
- Zayna Al-Husein, United States of America
- Lyn Finelli, United States of America
- Carlos Grijalva, United States of America
- Nadine Rouphael, United States of America
Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
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.