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

Daniel, Priya and Rodrigo, Chamira and Bewick, Thomas and Sheppard, Carmen and Greenwood, Sonia and McKeever, Tricia M. and Trotter, Caroline and Lim, Wei Shen (2018) 13-Valent vaccine serotype pneumococcal community acquired pneumonia in adults in high clinical risk groups. Vaccine, 36 (12). pp. 1614-1620. ISSN 0264-410X

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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 >/=65years with one or more clinical risk factors had a significantly lower risk of PCV-13 serotype CAP compared to those aged 16-64years 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.

Item Type: Article
Keywords: Streptococcus pneumoniae; Pneumonia; PCV-13, Serotypes; Vaccine
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Epidemiology and Public Health
Identification Number: https://doi.org/10.1016/j.vaccine.2018.02.005
Depositing User: Claringburn, Tara
Date Deposited: 20 Mar 2018 08:27
Last Modified: 20 Mar 2018 12:18
URI: http://eprints.nottingham.ac.uk/id/eprint/50518

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