Menéndez Rosario, Torres Antoni, España Pedro Pablo, Fernández-Villar Jose Alberto, Marimón José María, Méndez Raúl, Cilloniz Catia, Egurrola Mikel, Botana-Rial Maribel, Ercibengoa María, Méndez Cristina, Cifuentes Isabel, Gessner Bradford D
Hospital Universitario y Politécnico la Fe, 46026 Valencia, Spain.
Biomedical Research Center Network for Respiratory Diseases (CIBERES), 28029 Madrid, Spain.
Microorganisms. 2023 Nov 16;11(11):2781. doi: 10.3390/microorganisms11112781.
Newer higher valency pneumococcal conjugate vaccines (PCVs) have the potential to reduce the adult community-acquired pneumonia (CAP) burden. We describe the evolution and distribution of adult community-acquired pneumonia (CAP) serotypes in Spain, focusing on serotypes contained in the 20-valent PCV (PCV20). This was a prospective, observational study of chest X-ray (CXR)-confirmed CAP in immunocompetent adults hospitalized in one of four Spanish hospitals between November 2016 and November 2020. Pneumococci were isolated from cultures and detected in urine using BinaxNow and Pfizer serotype-specific urinary antigen tests UAD1 and UAD2. We included 1948 adults hospitalized with CXR-CAP. The median age was 69.0 years (IQR: 24 years). At least one comorbidity was present in 84.8% ( = 1653) of patients. At admission, 76.1% of patients had complicated pneumonia. Pneumococcus was identified in 34.9% ( = 680) of study participants. The PCV20 vaccine-type CAP occurred in 23.9% ( = 465) of all patients, 68.4% ( = 465) of patients with pneumococcal CAP, and 82.2% (83/101) of patients who had pneumococcus identified by culture. Serotypes 8 ( = 153; 7.9% of all CAP) and 3 ( = 152; 7.8% of all CAP) were the most frequently identified. Pneumococcus is a common cause of hospitalized CAP among Spanish adults and serotypes contained in PCV20 caused the majority of pneumococcal CAP.
新型高价肺炎球菌结合疫苗（PCV）有潜力减轻成人社区获得性肺炎（CAP）的负担。我们描述了西班牙成人社区获得性肺炎（CAP）血清型的演变和分布，重点关注20价PCV（PCV20）中包含的血清型。这是一项前瞻性观察性研究，研究对象为2016年11月至2020年11月期间在西班牙四家医院之一住院的免疫功能正常的成人中经胸部X线（CXR）确诊的CAP。从培养物中分离肺炎球菌，并使用BinaxNow以及辉瑞血清型特异性尿抗原检测UAD1和UAD2在尿液中进行检测。我们纳入了1948例因CXR-CAP住院的成人。中位年龄为69.0岁（四分位间距：24岁）。84.8%（n = 1653）的患者存在至少一种合并症。入院时，76.1%的患者患有复杂性肺炎。在34.9%（n = 680）的研究参与者中鉴定出肺炎球菌。PCV20疫苗型CAP发生在所有患者的23.9%（n = 465）、肺炎球菌性CAP患者的68.4%（n = 465）以及通过培养鉴定出肺炎球菌的患者的82.2%（83/101）中。血清型8（n = 153；占所有CAP的7.9%）和3（n = 152；占所有CAP的7.8%）是最常鉴定出的血清型。肺炎球菌是西班牙成人住院CAP的常见病因，PCV20中包含的血清型导致了大多数肺炎球菌性CAP。
