TY - JOUR
T1 - Pneumococcal conjugate serotype distribution and predominating role of serotype 3 in German adults with community-acquired pneumonia
AU - for the CAPNETZ study group
AU - Forstner, Christina
AU - Kolditz, Martin
AU - Kesselmeier, Miriam
AU - Ewig, Santiago
AU - Rohde, Gernot
AU - Barten-Neiner, Grit
AU - Rupp, Jan
AU - Witzenrath, Martin
AU - Welte, Tobias
AU - Pletz, Mathias W.
N1 - Funding Information:
CAPNETZ was founded by a German Federal Ministry of Education and Research grant ( 01KI07145 ) 2001-2011 . CF and MWP: are partly supported by a grant of the German Federal Ministry of Education and Research KliFo 2.0 (grant number 01KI1501 ). This study was supported by an unrestricted grant from Pfizer Germany. MKe was supported by the Integrated Research and Treatment Center – Center for Sepsis Control and Care (CSCC) at the Jena University Hospital funded by the German Federal Ministry of Education and Research ( BMBF No . 01EO1502 ).
Funding Information:
CF is a member of the speakers’ bureau for Basilea, MSD, Gilead and Pfizer outside the submitted work. MK reports personal fees from Pfizer and MSD and a research grant from Pfizer outside the submitted work. SE is member of the scientific advisory board of Pfizer. GR reports personal fees from Pfizer, Boehringer Ingelheim, Solvay, GSK, Essex Pharma, MSD, Grifols, Chiesi, Vertex, Roche and Novartis for lectures including service on speakers’ bureaus outside the submitted work and/or consultancy during advisory board meetings and personal fees from GSK for travel accommodations/meeting expenses, outside the submitted work. As part of her activity as a member of the executive bodies, GB-N reports economic connections to the following diagnostic and pharmaceutical companies: ThermoFisher Scientific/BRAHMS, Alere Technologies GmbH, Merck Sharp & Dohme Corp., Pfizer Pharma GmbH, R-Biopharm AG and Helmut Hund GmbH. MW received personal fees from Actelion, Astra Zeneca, Bayer Health Care, Berlin Chemie, Biotest, Chiesi, Hexal, Novartis, Roche, Teva, and research funding from Actelion, Bayer Health Care, Biotest, Boehringer Ingelheim, Noxxon, Silence Therapeutics, Vaxxilon, all unrelated to the current work. TW is the head of clinical studies and a member of the speakers’ bureau for Pfizer, GSK and MSD and is a consultant to Pfizer and MSD. MWP is a consultant to and a member of the speakers’ bureau for MSD, GSK and Pfizer, and has received research grants from Pfizer. JR and MKe have declared no conflict of interest
Publisher Copyright:
© 2019 Elsevier Ltd
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/1/29
Y1 - 2020/1/29
N2 - Introduction: Implementation of the 7-valent pneumococcal conjugate vaccine (PCV7) in infant vaccination programs has substantially reduced the burden of PCV7 serotypes also in adult community-acquired pneumonia (CAP). Currently, it is unclear, if this extensive herd protection effect can be extrapolated to the additional 6 serotypes included in the 13-valent pneumococcal conjugate vaccine (PCV13), which replaced PCV7 in Germany in 2010. Objectives: We investigated changing trends for PCV13 serotypes in adult CAP patients between three to seven years after implementation of PCV13 infant immunization in Germany. Methods: Between December 2012 and January 2017, urine samples from German adult patients with radiologically confirmed CAP were prospectively collected by the multi-center cohort study CAPNETZ and analyzed by the serotype-specific multiplex urinary antigen detection assay (SSUAD) allowing for the detection of PCV13 serotypes. Results: PCV13 serotypes were found in 59 of 796 (7.4%) patients with all-cause CAP, most prevalent was serotype 3 (30 of 59 patients, 50.8%). All patients with serotype 3-CAP were admitted to hospital and the majority required oxygen at admission (83.3% of patients with serotype 3-CAP versus 50.9% of patients with pneumococcal CAP by other serotypes, p = 0.005). Compared to SSUAD testing, conventional microbiological workup missed 27 of 30 (90.0%) serotype 3-CAP cases. We could not observe a time trend in the proportions of PCV13 serotypes and serotype 3 in all-cause CAP between 2013 and 2016 (OR trend per year 0.84, 95% CI 0.64–1.11 for PCV13 serotypes and OR trend per year 0.95, 95% CI 0.70–1.28 for serotype 3). Conclusions: Conventional methods underestimate serotype 3-CAP that can cause severe disease. Changes in overall PCV13 coverage were not detected during the years 2013 to 2016, mostly driven by a high proportion of serotype 3.
AB - Introduction: Implementation of the 7-valent pneumococcal conjugate vaccine (PCV7) in infant vaccination programs has substantially reduced the burden of PCV7 serotypes also in adult community-acquired pneumonia (CAP). Currently, it is unclear, if this extensive herd protection effect can be extrapolated to the additional 6 serotypes included in the 13-valent pneumococcal conjugate vaccine (PCV13), which replaced PCV7 in Germany in 2010. Objectives: We investigated changing trends for PCV13 serotypes in adult CAP patients between three to seven years after implementation of PCV13 infant immunization in Germany. Methods: Between December 2012 and January 2017, urine samples from German adult patients with radiologically confirmed CAP were prospectively collected by the multi-center cohort study CAPNETZ and analyzed by the serotype-specific multiplex urinary antigen detection assay (SSUAD) allowing for the detection of PCV13 serotypes. Results: PCV13 serotypes were found in 59 of 796 (7.4%) patients with all-cause CAP, most prevalent was serotype 3 (30 of 59 patients, 50.8%). All patients with serotype 3-CAP were admitted to hospital and the majority required oxygen at admission (83.3% of patients with serotype 3-CAP versus 50.9% of patients with pneumococcal CAP by other serotypes, p = 0.005). Compared to SSUAD testing, conventional microbiological workup missed 27 of 30 (90.0%) serotype 3-CAP cases. We could not observe a time trend in the proportions of PCV13 serotypes and serotype 3 in all-cause CAP between 2013 and 2016 (OR trend per year 0.84, 95% CI 0.64–1.11 for PCV13 serotypes and OR trend per year 0.95, 95% CI 0.70–1.28 for serotype 3). Conclusions: Conventional methods underestimate serotype 3-CAP that can cause severe disease. Changes in overall PCV13 coverage were not detected during the years 2013 to 2016, mostly driven by a high proportion of serotype 3.
UR - http://www.scopus.com/inward/record.url?scp=85075878854&partnerID=8YFLogxK
U2 - 10.1016/j.vaccine.2019.11.026
DO - 10.1016/j.vaccine.2019.11.026
M3 - Journal articles
C2 - 31761500
AN - SCOPUS:85075878854
SN - 0264-410X
VL - 38
SP - 1129
EP - 1136
JO - Vaccine
JF - Vaccine
IS - 5
ER -
