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Epidemiology of community-acquired pneumonia in the era of extended serotype-covering multivalent pneumococcal conjugate vaccines
- Source :
- Vaccine. 38:7747-7755
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Background South Korea has been providing 10-valent pneumococcal conjugate vaccine/(PCV10)/13-valent pneumococcal conjugate vaccine (PCV13) to children and 23-valent pneumococcal polysaccharide vaccine (PPSV23) to older adults as part of a national immunization program. Methods From September 2015 to August 2017, a prospective cohort study was conducted for adults aged ≥19 years with community-acquired pneumonia (CAP) at four university hospitals. All-cause and pneumococcal CAP incidence and mortality rates were evaluated on the basis of hospital catchment population. Serotype distribution of pneumococcal CAP was also evaluated. Results Among 2669 patients with CAP, 252 cases (9.4%) were pneumococcal CAP cases. The annual incidences of all-cause and pneumococcal CAP were 194.3 cases and 18.3 cases respectively, per 100,000 persons. Serotyped Streptococcus pneumoniae was identified in 107 cases (42.5%) through culture or a serotype-specific urinary antigen detection assay. Pneumococcal CAP caused by the PCV13 and PPSV23 serotypes were 50 cases (46.7% of serotyped pneumococcal CAP and 19.8% of pneumococcal CAP), and 83 cases (77.6% of serotyped pneumococcal CAP and 32.9% of pneumococcal CAP), respectively. The most prevalent serotype was 3 (n = 21, 19.6% of serotyped pneumococcal CAP), followed by 19A (n = 10, 9.3% of serotyped pneumococcal CAP) and 11A (n = 10, 9.3% of serotyped pneumococcal CAP). Compared with non-pneumococcal CAP patients, pneumococcal CAP patients were more likely to have a higher CURB-65 scores (P = 0.002). The overall 30-day mortality rate of pneumococcal CAP was higher than that of non-pneumococcal CAP (6.3% versus 5.6%; odds ratio [OR], 1.15; 95% confidence interval [CI], 0.67–1.96), but this trend was reversed in patients aged 65–74 years (4.2% versus 8.6%; OR, 0.47; 95% CI, 0.14–1.54). Conclusions The disease burden of PCV13-serotype pneumococcal CAP remains significantly high in Korean adults, particularly among elderly people, even after a high uptake of pediatric PCVs.
- Subjects :
- Adult
Serotype
medicine.medical_specialty
030231 tropical medicine
Population
Serogroup
medicine.disease_cause
Pneumococcal Infections
Pneumococcal conjugate vaccine
Pneumococcal Vaccines
Young Adult
03 medical and health sciences
0302 clinical medicine
Community-acquired pneumonia
Internal medicine
Republic of Korea
Streptococcus pneumoniae
Humans
Medicine
Prospective Studies
030212 general & internal medicine
Child
education
Aged
education.field_of_study
Vaccines, Conjugate
General Veterinary
General Immunology and Microbiology
business.industry
Incidence (epidemiology)
Public Health, Environmental and Occupational Health
Pneumonia, Pneumococcal
medicine.disease
Pneumococcal polysaccharide vaccine
Pneumonia
Infectious Diseases
Molecular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 0264410X
- Volume :
- 38
- Database :
- OpenAIRE
- Journal :
- Vaccine
- Accession number :
- edsair.doi.dedup.....4115fb2ba893840db1c7ca963e6e62d4