13-Valent vaccine serotype pneumococcal community acquired pneumonia in adults in high clinical risk groups

Priya Daniel*, Chamira Rodrigo, Thomas Bewick, Carmen Sheppard, Sonia Greenwood, Tricia M. McKeever, Caroline Trotter, Wei Shen Lim

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

There is debate regarding the value of vaccinating adults with the 13-valent pneumococcal conjugate vaccine (PCV-13). This analysis was conducted to investigate the risk of PCV-13 serotype community acquired pneumonia (CAP) in hospitalised adults with co-morbid disease and risk factors for pneumococcal disease in the UK. Consecutive adults hospitalised (2008–2013) with a primary diagnosis of CAP, were recruited. Pneumococcal aetiology disease was identified by use of pneumococcal urinary antigen detection and serotype identification using a validated multiplex immunoassay or serum latex agglutination. Adults with PCV-13 serotype CAP were compared to those with non-PCV-13 serotype CAP. Of 2224 patients, PCV-13 serotype CAP was identified in 337 (15.2%) and non-PCV-13 serotype CAP in 250 (11.2%) individuals. Adults aged ≥65 years with one or more clinical risk factors had a significantly lower risk of PCV-13 serotype CAP compared to those aged 16–64 years without clinical risk factors (aOR 0.61, 95%CI 0.41–0.92, p =.018). In a stacked-risk analysis, the presence of incremental clinical risk factors was associated with lower odds of PCV-13 disease (p for trend =.029) Adults with underlying chronic respiratory disease (aOR) 0.56, 95% CI 0.36–0.85, p =.007) and chronic kidney disease (aOR 0.48, 95% CI 0.25–0.92, p =.028) had significantly lower adjusted odds of PCV-13 compared to non-PCV-13 serotype CAP. This analysis suggests that in the UK, the burden of PCV13 disease is greater in adults outside the traditional ‘at-risk’ groups compared to adults in ‘at-risk’ groups.

Original languageEnglish
Pages (from-to)1614-1620
Number of pages7
JournalVaccine
Volume36
Issue number12
DOIs
Publication statusPublished - 14 Mar 2018

Bibliographical note

Funding Information:
This study was funded by an investigator initiated unrestricted grant from Pfizer (formerly Wyeth).

Publisher Copyright:
© 2018 Elsevier Ltd

Keywords

  • PCV-13
  • Pneumonia
  • Serotypes
  • Streptococcus pneumoniae
  • Vaccine

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