Resumen
Objective(s): In the context of age- and risk-based pneumococcal vaccine recommendations in Canada, this study presents updated data from active surveillance of pneumococcal community acquired pneumonia (pCAP) and invasive pneumococcal disease (IPD) in hospitalized adults from 2010 to 2017. Methods: S. pneumoniae was detected using culture (blood and sputum), and urine antigen detection (UAD). Serotyping was performed with Quellung, PCR, or using the PCV13- and PPV23 (non-PCV13)-specific UADs. Laboratory results, demographic, and outcome data were categorized by age (16–49, 50–64, and 65 + ) and by disease [non-bacteremic pCAP, bacteremic pCAP, and IPD(non-CAP)]. Results: 11,129 CAP cases and 216 cases of IPD (non-CAP) were identified. Laboratory testing for S. pneumoniae was performed in 8912 CAP cases, identifying 1264 (14.2%) as pCAP. Of pCAP cases, 811 (64.1%) were non-bacteremic and 455 (35.9%) were bacteremic. Adults 65 + years represented 54.5% of non-bacteremic pCAP, 41.4% of bacteremic pCAP, and 48.6% of IPD cases. Adults 50–64 years contributed 30.3%, 33.1%, and 29.9%, respectively. In pCAP, PCV13 serotypes declined between 2010 and 2014 due to declines in serotypes 7F and 19A, then plateaued from 2015 to 2017 with persistence of serotype 3. In later study years, non-bacteremic pCAP was predominant, and PPV23 (non-PCV13) serotypes increased from 2015 to 2017, with serotypes 22F, 11A, and 9 N being most frequently identified. Compared to non-pCAP, pCAP cases were more likely to be admitted to intensive care units and require mechanical ventilation. These outcomes and mortality were more common in bacteremic pCAP and IPD, versus non-bacteremic pCAP. Conclusion(s): Along with IPD, pCAP surveillance (bacteremic and non-bacteremic) is important as their trends may differ over time. With insufficient herd protection from PCV13 childhood immunization, or use of PPV23 in adults, this study supports direct adult immunization with PCV13 or higher valency conjugate vaccines to reduce the residual burden of pCAP and IPD.
Idioma original | English |
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Páginas (desde-hasta) | 2635-2646 |
Número de páginas | 12 |
Publicación | Vaccine |
Volumen | 40 |
N.º | 18 |
DOI | |
Estado | Published - abr. 20 2022 |
Nota bibliográfica
Funding Information:This work was supported by the Public Health Agency of Canada (PHAC), the Canadian Institutes of Health Research (CIHR), and by an investigator-initiated research grant to CIRN from Pfizer Canada. The authors would like to thank all CIRN SOS surveillance monitors, as well as staff at the Canadian Center for Vaccinology (CCfV), who were instrumental in the recruitment, collection, and processing of CAP and IPD specimens. Technical assistance of the laboratory staff at the Streptococcus and Sexual Transmitted Diseases Unit of the National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC) was greatly appreciated. The authors are indebted to Pfizer Laboratories for providing access to UAD-1 and UAD-2 testing.
Funding Information:
SAM received research grants from Pfizer supporting this investigator-initiated study, as well as other from GlaxoSmithKline (GSK) and Sanofi Pasteur; All authors participated on the investigator-initiated grants sponsored by Pfizer and JL and TH declare similar participating for studies sponsored by GSK; JL received research grants from Merck; LV received research grants from GSK, Pfizer, Optimer, Cubist and Merck, and personal fees from Merck, Optimer and Cubist. ML received grants from Pfizer. MKA reports grant funding from GSK and Sanofi and honoraria from Sanofi, Seqirus and Pfizer. No other conflicts were declared.
Funding Information:
This work was supported by the Public Health Agency of Canada (PHAC), the Canadian Institutes of Health Research (CIHR), and by an investigator-initiated research grant to CIRN from Pfizer Canada. The authors would like to thank all CIRN SOS surveillance monitors, as well as staff at the Canadian Center for Vaccinology (CCfV), who were instrumental in the recruitment, collection, and processing of CAP and IPD specimens. Technical assistance of the laboratory staff at the Streptococcus and Sexual Transmitted Diseases Unit of the National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC) was greatly appreciated. The authors are indebted to Pfizer Laboratories for providing access to UAD-1 and UAD-2 testing.
Publisher Copyright:
© 2022 The Author(s)
ASJC Scopus Subject Areas
- Molecular Medicine
- General Immunology and Microbiology
- General Veterinary
- Public Health, Environmental and Occupational Health
- Infectious Diseases
PubMed: MeSH publication types
- Journal Article
- Research Support, Non-U.S. Gov't