Lansbury, Louise, Lawrence, Hannah, McKeever, Tricia M, French, Neil 
ORCID: 0000-0003-4814-8293, Aston, Stephen ORCID: 0000-0002-0701-8364, Hill, Adam T, Pick, Harry, Baskaran, Vadsala, Edwards-Pritchard, Rochelle C, Bendall, Lesley et al (show 12 more authors)
(2024)
Pneumococcal serotypes and risk factors in adult community-acquired pneumonia 2018-20; a multicentre UK cohort study.
The Lancet regional health. Europe, 37.
100812-.
Abstract
<h4>Background</h4>Higher-valency pneumococcal vaccines are anticipated. We aimed to describe serotype distribution and risk factors for vaccine-serotype community-acquired pneumonia (CAP) in the two years pre-SARS-CoV-2 pandemic.<h4>Methods</h4>We conducted a prospective cohort study of adults hospitalised with CAP at three UK sites between 2018 and 2020. Pneumococcal serotypes were identified using a 24-valent urinary-antigen assay and blood cultures. Risk factors associated with vaccine-type pneumonia caused by serotypes in the 13-, 15- and 20-valent pneumococcal conjugate vaccines (PCV13, PCV15, PCV20) and 23-valent pneumococcal polysaccharide vaccine (PPV23) were determined from multivariable analysis.<h4>Findings</h4>Of 1921 adults hospitalised with CAP, 781 (40.7%, 95% confidence intervals (CI) 38.5-42.9%) had pneumococcal pneumonia. A single PCV13-serotype was detected in 242 (31.0%, 95% CI 27.8-34.3%) pneumococcal CAP patients, mostly serotype 3 (171/242, 70.7%, 95% CI 64.5-76.0%). The additional two PCV15-serotypes were detected in 31 patients (4%, 95% CI 2.8-5.6%), and PCV20-non13-serotypes in 192 (24.6%), with serotype 8 most prevalent (123/192, 64.1%, 95% CI 57.1-70.5%). Compared to PCV13-serotype CAP, people with PCV20-non13 CAP were younger (median age 62 versus 72 years, p < 0.001) and less likely to be male (44% versus 61%, p = 0.01). PPV23-non13-serotypes were found in 252 (32.3%, 95% CI 29.1-35.6%) pneumococcal CAP patients.<h4>Interpretation</h4>Despite mature infant pneumococcal programmes, the burden of PCV13-serotype pneumonia remains high in older adults, mainly due to serotype 3. PCV20-non13-serotype pneumonia is more likely in younger people with fewer pneumococcal risk factors.<h4>Funding</h4>Unrestricted investigator-initiated research grant from Pfizer, United Kingdom; support from National Institute for Health Research (NIHR) Biomedical Research Centre, Nottingham.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Pneumococcal vaccines, Pneumonia, Risk factors, Serogroup, Streptococcus pneumoniae |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 02 Jan 2024 15:53 |
| Last Modified: | 02 Feb 2024 14:15 |
| DOI: | 10.1016/j.lanepe.2023.100812 |
| Open Access URL: | https://www.thelancet.com/journals/lanepe/article/... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3177643 |
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