Prevalence, Clinical Severity, and Serotype Distribution of Pneumococcal Pneumonia Among Adults Hospitalized With Community-Acquired Pneumonia in Tennessee and Georgia, 2018–2022
Wesley H. Self, Kelly Johnson, Jackson Resser, Cynthia G. Whitney, Adrienne Baughman, Mai Kio, Carlos G. Grijalva, Jessica Traenkner, Jakea Johnson, Karen F. Miller, Christina A. Rostad, İnci Yıldırım, Luis W Salazar, Ralph Tanios, Sydney A. Swan, Yuwei Zhu, Jin H. Han, Thomas Weiß, Craig S. Roberts, Nadine Rouphael, For the PNEUMO Study Investigators, Wesley H. Self, J Jackson Resser, Adrienne Baughman, Carlos G. Grijalva, Jakea Johnson, Karen F. Miller, Sydney A Swan, Yuwei Zhu, Jin H. Han, Sabrina Shipman, Nadine Rouphael, Cynthia G. Whitney, Mai Kio, Jessica Traenkner, Christina A. Rostad, İnci Yıldırım, Laurel Bristow, Luis Salazar, Zayna Al-Husein, Evan J. Anderson, Ifeyinwa Benyeogor, Andrew Cheng, Jong-Ha Choi, Khalel De Castro, Ana Drobeniuc, Kieffer Hellmeister, Ariel Kay, Matthew Lee, Vikash Patel, Olivia Reese, Veronica Smith, Ralph Tanios, Elizabeth Grace Taylor, Megan Taylor, Wesley Washington, Cecilia Zhang, Kelly Johnson, Thomas Weiß, Craig S. Roberts, Madelyn Ruggieri
Abstract
INTRODUCTION: Understanding the pneumococcal serotypes causing community-acquired pneumonia (CAP) is essential for evaluating the impact of pneumococcal vaccines. METHODS: We conducted a prospective surveillance study of adults aged ≥18 years hospitalized with CAP at 3 hospitals in Tennessee and Georgia between 1 September 2018 and 31 October 2022. We assessed for pneumococcal etiology with cultures, the BinaxNOW urinary antigen detection test, and serotype-specific urinary antigen detection assays that detect 30 pneumococcal serotypes contained in the investigational pneumococcal conjugate vaccine V116, as well as licensed vaccines PCV15 and PCV20 (except serotype 15B). The distribution of pneumococcal serotypes was calculated based on serotype-specific urinary antigen detection results. RESULTS: Among 2917 hospitalized adults enrolled with CAP, 352 (12.1%) patients had Streptococcus pneumoniae detected, including 51 (1.7%) patients with invasive pneumococcal pneumonia. The 8 most commonly detected serotypes were: 3, 22F, 19A, 35B, 9N, 19F, 23A, and 11A. Among 2917 adults with CAP, 272 (9.3%) had a serotype detected that is contained in V116, compared to 196 (6.7%) patients with a serotype contained in PCV20 (P < .001), and 168 (5.8%) patients with a serotype contained in PCV15 (P < .001). A serotype contained in V116 but not PCV15 or PCV20 was detected in 120 (4.1%) patients, representing 38.0% of serotype detections. CONCLUSIONS: Approximately 12% of adults hospitalized with CAP had S. pneumoniae detected, and approximately one-third of the detected pneumococcal serotypes were not contained in PCV15 or PCV20. Development of new pneumococcal vaccines with expanded serotype coverage has the potential to prevent a substantial burden of disease.