Ramirez Julio A, Hubler Robin A, Ali Mohammad, Gray Sharon L, Carrico Ruth, McNaughton Candace D, Wunderink Richard G, Dela Cruz Charles S, Chilson Erica L, Cané Alejandro D, Isturiz Raul E, Pride Michael W, Jodar Luis, Gessner Bradford D, Grant Lindsay R
Norton Infectious Diseases Institute, Norton Healthcare, Louisville, Kentucky, USA.
Division of Infectious Diseases, University of Louisville, Louisville, Kentucky, USA.
Open Forum Infect Dis. 2024 Dec 17;12(1):ofae727. doi: 10.1093/ofid/ofae727. eCollection 2025 Jan.
Serotype-specific urinary antigen detection (UAD) assay results can be used to estimate the serotype contribution among adults with pneumococcal community-acquired pneumonia (CAP) and to guide recommendations regarding higher-valency pneumococcal conjugate vaccines (PCVs).
Adults aged ≥18 years hospitalized with radiographic evidence of CAP were prospectively enrolled in 4 US cities from November 2019 to December 2020, overlapping the coronavirus disease 2019 (COVID-19) pandemic. Data were collected by patient interview and medical chart review. was isolated from standard-of-care respiratory samples and blood; urine collected per-protocol was tested by BinaxNOW and UAD assays. The proportions of adults with radiologically confirmed CAP (RAD CAP) testing positive for and for serotypes contained in PCV13, PCV15, and PCV20 were calculated.
Among 3098 adults enrolled, 2105 (67.9%) had RAD CAP. Of these, 44.3% were ≥65 years of age, and most had a chronic medical condition (46.0%) or were immunocompromised (38.5%). was detected by any method in 214 (10.2%) RAD CAP participants, including 63 (3.0%) with serotypes covered by PCV13, 81 (3.9%) by PCV15, and 119 (5.7%) by PCV20. and PCV serotype positivity were higher before the pandemic (November 2019-April 2020) compared to during the COVID-19 pandemic (May 2020-December 2020).
Our study demonstrated that despite the COVID-19 pandemic, PCV serotype pneumococcus continued to cause an important proportion of adult CAP in the US. These data are useful for informing PCV recommendations and for establishing an epidemiologic baseline to assess the impact of such recommendations.
血清型特异性尿抗原检测（UAD）分析结果可用于估计成人肺炎球菌社区获得性肺炎（CAP）患者中各血清型的构成情况，并指导有关更高价肺炎球菌结合疫苗（PCV）的推荐建议。
2019年11月至2020年12月期间，在美国4个城市前瞻性纳入了年龄≥18岁且有CAP影像学证据的住院成人患者，该时间段与2019冠状病毒病（COVID-19）大流行时间重叠。通过患者访谈和病历审查收集数据。从标准护理呼吸道样本和血液中分离出[病原体名称未给出]；按照方案收集的尿液通过BinaxNOW和UAD分析进行检测。计算了经放射学确诊的CAP（RAD CAP）成人患者中[病原体名称未给出]检测呈阳性以及PCV13、PCV15和PCV20中所含血清型检测呈阳性的比例。
在纳入的3098名成人患者中，2105名（67.9%）有RAD CAP。其中，44.3%年龄≥65岁，大多数患有慢性疾病（46.0%）或免疫功能低下（38.5%）。在214名（10.2%）RAD CAP参与者中通过任何方法检测到了[病原体名称未给出]，包括63名（3.0%）感染了PCV13涵盖的血清型，81名（3.9%）感染了PCV15涵盖的血清型，119名（5.7%）感染了PCV20涵盖的血清型。与COVID-19大流行期间（2020年5月至12月）相比，在大流行之前（2019年11月至2020年4月）[病原体名称未给出]和PCV血清型阳性率更高。
我们的研究表明，尽管有COVID-19大流行，但PCV血清型肺炎球菌在美国成人CAP中仍占相当比例。这些数据有助于为PCV推荐建议提供信息，并建立一个流行病学基线以评估此类建议的影响。
