Abstract
Background and objective: Widespread use of PCV7/PCV13 in children has resulted in a significant reduction of pneumococcal diseases in adults. Pneumococcal pneumonias due to PCV13 vaccine serotypes particularly in CAP without bacteremia are not known. In Spain, where PCV13 is mainly available in private market for healthy children (estimated uptake ≈70%), we assessed the burden of disease caused by PCV13 serotypes in immunocompetent subjects >18 years hospitalized with CAP in 3 Spanish hospitals (November 2011-May 2013).
Methods: In subjects hospitalized with CAP, microbiological confirmation was sought by the novel UAD (Pfizer's PCV13 serotype specific urinary antigen detection test), BinaxNow & conventional cultures. Serotyping of pneumococcal isolates was accomplished in a central laboratory using Quellung reaction.
Results: S. pneumoniae infection was microbiologically confirmed in 232 cases (30.7%) of 756 enrolled patients by any diagnostic test. Positivity rates for the different tests were: UAD: 63%; BinaxNow: 57.3%; blood cultures: 16.8%; pleural fluid culture: 2.5%; sputum: 9.4% and others: 0.8%. Table shows PCV13 vaccine type distribution in invasive1 and non-invasive2 pneumococcal CAP.
Conclusion: Almost 20% of hospitalized CAP in immunocompetent adults in Spain were caused by one of the serotypes included in PCV13.
- © 2014 ERS
