1468. PCV13 Serotype Trends Over Time in Pneumococcal Community Acquired Pneumonia: Which Method(s) Work Best?
Session: Poster Abstract Session: Respiratory Infections: CAP
Friday, October 5, 2018
Room: S Poster Hall
Background: Recent study have shown that a 13-valent pneumococcal conjugate vaccine (PCV13) was effective at preventing vaccine-type pneumococcal community acquired pneumonia (CAPSpn) in healthy adults. With the anticipated herd immunity from routine infant immunization with PCV13 used since 2010, the benefits of adult immunization in Canada were unclear and surveillance for CAPSpn with serotype distributions was needed. This study aimed to compare PCV13 serotype trends in CAPSpn from 2010 to 2015 using various laboratory methods.

Methods: Active surveillance for CAP was performed from 2010 to 2015 in adult hospitals across five Canadian provinces. Bacteremic CAPSpn cases were identified using blood culture, and non-bacteremic CAPSpn cases by sputum culture or using a PCV13-specific urine antigen detection (UADPCV13). Serotype was assigned using Quellung reaction, PCR, or UADPCV13. CAPSpn cases were categorized by laboratory test(s), age, or disease (bacteremic or non-bacteremic CAPSpn).

Results: A diagnostic test for S. pneumoniae was performed on 6687 CAP cases. S. pneumoniae positivity decreased from 2011 to 2014, and increased again in 2015. PCV13 serotypes followed a similar trend, where the decline in PCV13 serotypes attributed to serotypes 7F and 19A was noted, and the proportion of serotype 3 increased over time. Similar trends were seen regardless of whether data was categorized by laboratory test(s), age, or disease.

Conclusion: Our data suggests that all methods showed similar trends in PCV13 serotype distribution over 2010 to 2015. Herd immunity through childhood immunization with PCV13 was evident, but insufficient to afford complete protection to hospitalized adults. CAPSpn remained a significant cause of morbidity and mortality in hospitalized adult, and serotype 3 seems to be persisting despite herd immunity seen with other serotypes. Ongoing surveillance is required.

Jason Leblanc, PhD1, May Elsherif, MD1, Lingyun Ye, MSc1, Donna Mackinnon-Cameron, MMath1, Ardith Ambrose, RN1, Todd Hatchette, MD FRCPC1, Irene Martin, BSc2, Melissa K Andrew, MD, PhD1, Guy Boivin, MD, MSc3, William R. Bowie, MD, FRCPC, FIDSA4, Karen Green, MSc, RN5, Jennie Johnstone, MD, PhD6,7, Mark Loeb, MD, MSc7, Anne Mccarthy, MD, MSc8, Allison McGeer, MD, MSc5, Makeda Semret, MD9, Sylvie Trottier, MD, PhD3, Louis Valiquette, MD, MSc, FRCPC10, Duncan Webster, MD11 and Shelly A McNeil, MD, FIDSA1, (1)Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada, (2)National Microbiology Laboratory, Winnipeg, MB, Canada, (3)Centre Hospitalier Universitaire de Quebec, Quebec City, QC, Canada, (4)Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada, (5)Mount Sinai Hospital, Toronto, ON, Canada, (6)Public Health Ontario, Toronto, ON, Canada, (7)McMaster University, Hamilton, ON, Canada, (8)The Ottawa Hospital, Ottawa, ON, Canada, (9)McGill University, Montreal, QC, Canada, (10)Microbiology and Infectious Disease, Université de Sherbrooke, Sherbrooke, QC, Canada, (11)Saint John Regional Hospital, Dalhousie University, Saint John, NB, Canada

Disclosures:

J. Leblanc, None

M. Elsherif, None

L. Ye, None

D. Mackinnon-Cameron, None

A. Ambrose, None

T. Hatchette, GSK: Grant Investigator , Research grant . Pfizer: Grant Investigator , Research grant . Abbvie: Consultant , Speaker honorarium .

I. Martin, None

M. K. Andrew, GSK: Grant Investigator , Research grant . Pfizer: Grant Investigator , Research grant . Sanofi Pasteur: Grant Investigator , Research grant .

G. Boivin, None

W. R. Bowie, None

K. Green, None

J. Johnstone, None

M. Loeb, None

A. Mccarthy, None

A. McGeer, GSK: Grant Investigator , Research grant . Hoffman La Roche: Grant Investigator , Research grant . Sanofi Pasteur: Grant Investigator , Research grant .

M. Semret, GSK: Grant Investigator , Research grant . Pfizer: Grant Investigator , Research grant .

S. Trottier, CIHR: Grant Investigator , Research grant .

L. Valiquette, None

D. Webster, None

S. A. McNeil, GSK: Grant Investigator , Research grant . Pfizer: Grant Investigator , Research grant . Merck: Collaborator and Consultant , Contract clinical trials and Speaker honorarium . Novartis: Collaborator , Contract clinical trials . Sanofi Pasteur: Collaborator , Contract clinical trials .

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