1582. Distribution of PCV13 Pneumococcal Serotypes in Patients with Community-Acquired Pneumonia Presenting at 20 US Hospitals
Session: Poster Abstract Session: Community Acquired Pneumonia
Saturday, October 10, 2015
Room: Poster Hall
Background: In September 2014, PCV13 was recommended by the Advisory Committee on Immunization Practices (ACIP) for all adults ≥ 65 years old to prevent pneumococcal pneumonia. Since the incidence of PCV13 pneumococcal serotypes in adults with Community-Acquired Pneumonia (CAP) is not well defined, the number of cases that the vaccine may prevent is undefined. The objective of this study was to estimate the incidence and distribution of PCV13 pneumococcal serotypes in US adults presenting to a study hospital with CAP.   Methods: This is an ongoing prospective, multicenter, study inclusive of 20 US hospitals. Interim data are presented from October 7, 2013 to October 31, 2014. Eligible patients included adults ≥18 years old with radiographically-confirmed CAP.  Patients with pneumococcal vaccination within prior 30 days were excluded from the analysis. S. pneumoniae was detected via blood cultures, Binax-NOW® urine assay (which detects a polysaccharide common to all pneumococcal serotypes) and a serotype-specific urinary antigen detection (UAD) assay which identifies PCV13 serotypes. Respiratory cultures were recorded if standard of care.      Results: A total of 2,674 eligible adults were included in the analysis. Median age 64 years, 1,299 (49%) were ≥65 years and 1,410 (53%) were females.  Most prevalent risk conditions were COPD (38%) and current smoker (28%).    S. pneumoniae was detected in 378 (14%) patients by any method with 226 (8.5 %) detected by UAD (see figure 1).   PCV 13 serotypes were present in 228 (8.5%) patients; serotype 5 was the most common (see Table 1). Two different serotypes were simultaneously detected in 39 patients.   Conclusion: PCV13 serotypes were detected in 8.5% of patients with CAP. These results indicate a persistent burden of adult pneumonia caused by vaccine serotypes, and the appropriateness of current ACIP recommendations.
    Table 1: PCV 13 serotypes from Culture or UAD
  PCV13 Pneumococcal Serotype Patients Positive for Serotype n (% of 2674 enrolled)
  4  2 (0.1)
  6B 0
Serotypes 9V 4 (0.1)
in PCV7 14 27 (1.0)
  18C 11 (0.4)
  19F  7 (0.3)
  23F 11 (1.7)
  1 1 (0)
  3 22 (0.8)
Additional 5 111 (4.2)
serotypes 6A 11 (0.4)
in PCV13 7F 15 (0.6)
  19A 40 (1.5)
  ≥ 1 PCV13 serotype 228 (8.5)
      Figure 1: Distribution of Positive Tests for S. pneumoniae by any assay (N=378)  
Julio Ramirez, MD, FIDSA1, Ronika Alexander, RN MAEd2, Ruth Carrico, PhD, RN, FSHEA, CIC1, Kimbal Ford, PharmD3,4, Sharon Gray, MS2, Michael Pride, PhD5, Shite Sebastian, PhD6, Qin Jiang, MS7, Paula Peyrani, MD1,8 and Raul Isturiz, MD9, (1)Division of Infectious Diseases, University of Louisville, Louisville, KY, (2)Global Vaccines, Pfizer Inc, Collegeville, PA, (3)Pfizer, Inc, New York, NY, (4)US Medical Affairs, Pfizer, Inc, New York, NY, (5)Vaccine Res. East and Early Development, Pfizer Res., Pfizer, Pearl River, NY, (6)Vaccine Research, Pfizer Inc, Pearl River, NY, (7)Pfizer Inc, Collegeville, PA, (8)Infectious Diseases, University of Louisville, Louisville, KY, (9)Pfizer Inc., New York, NY

Disclosures:

J. Ramirez, None

R. Alexander, Pfizer: Employee , Salary

R. Carrico, None

K. Ford, Pfizer: Employee , Salary

S. Gray, Pfizer: Employee and Shareholder , Salary

M. Pride, Pfizer: Employee , Salary

S. Sebastian, Pfizer: Employee , Salary

Q. Jiang, Pfizer: Employee , Salary

P. Peyrani, None

R. Isturiz, Pfizer: Employee and Shareholder , Salary

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