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

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 pneumococ...

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Main Authors: Daniel, Priya, Rodrigo, Chamira, Bewick, Thomas, Sheppard, Carmen, Greenwood, Sonia, McKeever, Tricia M., Trotter, Caroline, Lim, Wei Shen
Format: Article
Language:English
Published: Elsevier 2018
Subjects:
Online Access:https://eprints.nottingham.ac.uk/50518/
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author Daniel, Priya
Rodrigo, Chamira
Bewick, Thomas
Sheppard, Carmen
Greenwood, Sonia
McKeever, Tricia M.
Trotter, Caroline
Lim, Wei Shen
author_facet Daniel, Priya
Rodrigo, Chamira
Bewick, Thomas
Sheppard, Carmen
Greenwood, Sonia
McKeever, Tricia M.
Trotter, Caroline
Lim, Wei Shen
author_sort Daniel, Priya
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-505182019-02-10T04:30:16Z https://eprints.nottingham.ac.uk/50518/ 13-Valent vaccine serotype pneumococcal community acquired pneumonia in adults in high clinical risk groups Daniel, Priya Rodrigo, Chamira Bewick, Thomas Sheppard, Carmen Greenwood, Sonia McKeever, Tricia M. Trotter, Caroline Lim, Wei Shen 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. Elsevier 2018-03-14 Article PeerReviewed application/pdf en cc_by_nc_nd https://eprints.nottingham.ac.uk/50518/1/PCV%2013%20disease%20in%20high%20clinical%20risk%20groups%20%28CLEAN%29%20%28002%29.pdf Daniel, Priya, Rodrigo, Chamira, Bewick, Thomas, Sheppard, Carmen, Greenwood, Sonia, McKeever, Tricia M., 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 Streptococcus pneumoniae; Pneumonia; PCV-13 Serotypes; Vaccine https://www.sciencedirect.com/science/article/pii/S0264410X18301695?via%3Dihub 10.1016/j.vaccine.2018.02.005 10.1016/j.vaccine.2018.02.005 10.1016/j.vaccine.2018.02.005
spellingShingle Streptococcus pneumoniae; Pneumonia; PCV-13
Serotypes; Vaccine
Daniel, Priya
Rodrigo, Chamira
Bewick, Thomas
Sheppard, Carmen
Greenwood, Sonia
McKeever, Tricia M.
Trotter, Caroline
Lim, Wei Shen
13-Valent vaccine serotype pneumococcal community acquired pneumonia in adults in high clinical risk groups
title 13-Valent vaccine serotype pneumococcal community acquired pneumonia in adults in high clinical risk groups
title_full 13-Valent vaccine serotype pneumococcal community acquired pneumonia in adults in high clinical risk groups
title_fullStr 13-Valent vaccine serotype pneumococcal community acquired pneumonia in adults in high clinical risk groups
title_full_unstemmed 13-Valent vaccine serotype pneumococcal community acquired pneumonia in adults in high clinical risk groups
title_short 13-Valent vaccine serotype pneumococcal community acquired pneumonia in adults in high clinical risk groups
title_sort 13-valent vaccine serotype pneumococcal community acquired pneumonia in adults in high clinical risk groups
topic Streptococcus pneumoniae; Pneumonia; PCV-13
Serotypes; Vaccine
url https://eprints.nottingham.ac.uk/50518/
https://eprints.nottingham.ac.uk/50518/
https://eprints.nottingham.ac.uk/50518/