Serotype distribution in non-bacteremic pneumococcal pneumonia: association with disease severity and implications for pneumococcal conjugate vaccines.

<h4>Background</h4>There is limited knowledge of serotypes that cause non-bacteremic pneumococcal pneumonia (NBP). Here we report serotypes, their associated disease potential and coverage of pneumococcal conjugate vaccines (PCV) in adults with NBP and compare these to bacteremic pneumon...

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Autores principales:	Thomas Benfield, Marlene Skovgaard, Henrik Carl Schønheyder, Jenny Dahl Knudsen, Jette Bangsborg, Christian Østergaard, Hans-Christian Slotved, Helle Bossen Konradsen, Reimar Wernich Thomsen, Lotte Lambertsen
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/62110abd8dcc40eeb2b5b57a5493e67e
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spelling	oai:doaj.org-article:62110abd8dcc40eeb2b5b57a5493e67e2021-11-18T08:58:22ZSerotype distribution in non-bacteremic pneumococcal pneumonia: association with disease severity and implications for pneumococcal conjugate vaccines.1932-620310.1371/journal.pone.0072743https://doaj.org/article/62110abd8dcc40eeb2b5b57a5493e67e2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24009703/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>There is limited knowledge of serotypes that cause non-bacteremic pneumococcal pneumonia (NBP). Here we report serotypes, their associated disease potential and coverage of pneumococcal conjugate vaccines (PCV) in adults with NBP and compare these to bacteremic pneumonia (BP).<h4>Methods</h4>Adults with pneumonia and Streptococcus pneumoniae isolated from the lower respiratory tract or blood were included 1 year in a population-based design in Denmark. Pneumonia was defined as a new infiltrate on chest radiograph in combination with clinical symptoms or elevated white blood count or plasma C-reactive protein. All isolates were serotyped using type-specific pneumococcal rabbit antisera. All values are medians with interquartile ranges.<h4>Results</h4>There were 272 cases of NBP and 192 cases of BP. Ninety-nine percent were hospitalized. NBP and BP cases were of comparable age and sex but NBP cases had more respiratory symptoms and less severe disease compared to BP cases. In total, 46 different serotypes were identified. Among NBP cases, 5 serotypes accounted for nearly a third of isolates. PCV10 and -13 types covered 17% (95% confidence interval (CI): 11-23%) and 34% (95% CI: 25-43%) of NBP isolates, respectively. In contrast, the five most frequent serotypes accounted for two-thirds of BP isolates. PCV10 and -13 types covered 39% (95% CI: 30-48%) and 64% (95% CI: 48-79) of BP isolates, respectively. More severe NBP disease was associated with infection with invasive serotypes while there was an inverse relationship for BP.<h4>Conclusions</h4>Only a third of cases of adult non-bacteremic pneumococcal pneumonia would potentially be preventable with the use of PCV13 and just one sixth of cases with the use of PCV10 indicating that PCVs with increased valency are needed to increase vaccine coverage for NBP in adults. PCV13 could potentially prevent two-thirds of adult bacteremic pneumococcal pneumonia.Thomas BenfieldMarlene SkovgaardHenrik Carl SchønheyderJenny Dahl KnudsenJette BangsborgChristian ØstergaardHans-Christian SlotvedHelle Bossen KonradsenReimar Wernich ThomsenLotte LambertsenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 8, p e72743 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thomas Benfield Marlene Skovgaard Henrik Carl Schønheyder Jenny Dahl Knudsen Jette Bangsborg Christian Østergaard Hans-Christian Slotved Helle Bossen Konradsen Reimar Wernich Thomsen Lotte Lambertsen Serotype distribution in non-bacteremic pneumococcal pneumonia: association with disease severity and implications for pneumococcal conjugate vaccines.
description	<h4>Background</h4>There is limited knowledge of serotypes that cause non-bacteremic pneumococcal pneumonia (NBP). Here we report serotypes, their associated disease potential and coverage of pneumococcal conjugate vaccines (PCV) in adults with NBP and compare these to bacteremic pneumonia (BP).<h4>Methods</h4>Adults with pneumonia and Streptococcus pneumoniae isolated from the lower respiratory tract or blood were included 1 year in a population-based design in Denmark. Pneumonia was defined as a new infiltrate on chest radiograph in combination with clinical symptoms or elevated white blood count or plasma C-reactive protein. All isolates were serotyped using type-specific pneumococcal rabbit antisera. All values are medians with interquartile ranges.<h4>Results</h4>There were 272 cases of NBP and 192 cases of BP. Ninety-nine percent were hospitalized. NBP and BP cases were of comparable age and sex but NBP cases had more respiratory symptoms and less severe disease compared to BP cases. In total, 46 different serotypes were identified. Among NBP cases, 5 serotypes accounted for nearly a third of isolates. PCV10 and -13 types covered 17% (95% confidence interval (CI): 11-23%) and 34% (95% CI: 25-43%) of NBP isolates, respectively. In contrast, the five most frequent serotypes accounted for two-thirds of BP isolates. PCV10 and -13 types covered 39% (95% CI: 30-48%) and 64% (95% CI: 48-79) of BP isolates, respectively. More severe NBP disease was associated with infection with invasive serotypes while there was an inverse relationship for BP.<h4>Conclusions</h4>Only a third of cases of adult non-bacteremic pneumococcal pneumonia would potentially be preventable with the use of PCV13 and just one sixth of cases with the use of PCV10 indicating that PCVs with increased valency are needed to increase vaccine coverage for NBP in adults. PCV13 could potentially prevent two-thirds of adult bacteremic pneumococcal pneumonia.
format	article
author	Thomas Benfield Marlene Skovgaard Henrik Carl Schønheyder Jenny Dahl Knudsen Jette Bangsborg Christian Østergaard Hans-Christian Slotved Helle Bossen Konradsen Reimar Wernich Thomsen Lotte Lambertsen
author_facet	Thomas Benfield Marlene Skovgaard Henrik Carl Schønheyder Jenny Dahl Knudsen Jette Bangsborg Christian Østergaard Hans-Christian Slotved Helle Bossen Konradsen Reimar Wernich Thomsen Lotte Lambertsen
author_sort	Thomas Benfield
title	Serotype distribution in non-bacteremic pneumococcal pneumonia: association with disease severity and implications for pneumococcal conjugate vaccines.
title_short	Serotype distribution in non-bacteremic pneumococcal pneumonia: association with disease severity and implications for pneumococcal conjugate vaccines.
title_full	Serotype distribution in non-bacteremic pneumococcal pneumonia: association with disease severity and implications for pneumococcal conjugate vaccines.
title_fullStr	Serotype distribution in non-bacteremic pneumococcal pneumonia: association with disease severity and implications for pneumococcal conjugate vaccines.
title_full_unstemmed	Serotype distribution in non-bacteremic pneumococcal pneumonia: association with disease severity and implications for pneumococcal conjugate vaccines.
title_sort	serotype distribution in non-bacteremic pneumococcal pneumonia: association with disease severity and implications for pneumococcal conjugate vaccines.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/62110abd8dcc40eeb2b5b57a5493e67e
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Serotype distribution in non-bacteremic pneumococcal pneumonia: association with disease severity and implications for pneumococcal conjugate vaccines.

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