13-Valent vaccine serotype pneumococcal community acquired pneumonia in adults in high clinical risk groups |
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| Affiliation: | 1. Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham NG5 1PB, UK;2. Department of Respiratory Medicine, Derby Teaching Hospitals NHS Foundation Trust, Derby DE22 3NE, UK;3. Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England, Microbiology Services Division, Colindale Avenue, London NW9 5EQ, UK;4. Division of Epidemiology, University of Nottingham, Clinical Skills Building, Nottingham City Hospital Campus, Hucknall Road, Nottingham NG5 1PB, UK;5. Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK;1. Paris Descartes University, APHP Cochin Hospital, Rheumatology Department, Paris, France;2. Mohammed V University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology, El Ayachi Hospital, Rheumatology Department, Rabat, Morocco;3. Division of Infectious Diseases, Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR, USA;4. Paris Descartes University, AP-HP Cochin Hospital, CIC Cochin Pasteur, Inserm, CIC 1417, Paris, France;1. Department of Nursing, Hospital Universitari de Bellvitge, Institut d''Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain;2. Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d''Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain;3. School of Health Science, Blanquerna-Ramon Llull University, Barcelona, Spain;4. Spanish Network for Research in Infectious Diseases (REIPI), Spain;5. School of Nursing, University of Barcelona, Barcelona, Spain;6. Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Institut d''Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain;7. Faculty of Medicine, Department of Clinical Sciences, University of Barcelona, Barcelona, Spain;1. Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France;2. ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France;3. Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France;4. AFPA, Association Française de Pédiatrie Ambulatoire, Chambéry, France;5. Unité Court Séjour, Petits Nourrissons, Service de Néonatologie, Centre Hospitalier Intercommunal de Créteil, France;6. National Reference Center for Pneumococci, Laboratoire de Microbiologie, Assistance Publique-Hôpitaux de Paris, Hopital Européen Georges-Pompidou, Paris, France;7. Univ Paris Diderot, Sorbonne Paris Cité, France;8. Service de Microbiologie, Hôpital Robert-Debré, 75019 Paris, France;1. Prince Sultan Military Medical City, Riyadh, Saudi Arabia;2. Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia;3. General Directorate of Health Affairs in Makkah Region, Makkah, Saudi Arabia;4. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;5. General Directorate of Health Affairs in Medina Region, Medina, Saudi Arabia;6. Holy Makkah Municipality, Makkah, Saudi Arabia;7. Merck & Co., Inc., Kenilworth, NJ, USA;1. National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Kids Research Institute at The Children''s Hospital at Westmead, Westmead, NSW 2145, Australia;2. School of Public Health, The University of Sydney, Sydney, New South Wales, Australia;3. Saudi Food and Drug Authority, Riyadh, Saudi Arabia;4. The Discipline of Child and Adolescent Health, The Children''s Hospital at Westmead Clinical School, The University of Sydney Medical School, Australia;5. Faculty of Medicine, University of Tripoli, Ain Zara, Tripoli, Libya;6. California University of Science and Medicine, USA;7. Medical Development and Scientific/Clinical Affairs, Pfizer Vaccines, Dubai, United Arab Emirates;8. Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney, Australia;9. WHO Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events, Flinders University, Adelaide, Australia |
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| 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. |
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| Keywords: | Pneumonia PCV-13 Serotypes Vaccine |
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