Serotype Distribution and Disease Severity in Adults Hospitalized with Streptococcus pneumoniae Infection, Bristol and Bath, UK, 2006‒2022

Catherine Hyams; Robert J Challen; David Hettle; Zahin Amin-Chowdhury; Charli Grimes; Gabriella Ruffino; Rauri Conway; Robyn Heath; Paul  North; Adam S Malin; Nick A Maskell; Philip B Williams; O Martin Williams; Shamez Ladhani; Leon Danon; Adam H R Finn

doi:10.1101/2023.03.30.23287917

Serotype Distribution and Disease Severity in Adults Hospitalized with Streptococcus pneumoniae Infection, Bristol and Bath, UK, 2006‒2022

Catherine Hyams^*
, Robert J Challen
, David Hettle
, Zahin Amin-Chowdhury
, Charli Grimes
, Gabriella Ruffino
, Rauri Conway
, Robyn Heath
, Paul North
, Adam S Malin
, Nick A Maskell
, Philip B Williams
, O Martin Williams
, Shamez Ladhani
, Leon Danon
, Adam H R Finn

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

26 Citations (Scopus)

Abstract

Ongoing surveillance after pneumococcal conjugate vaccination (PCV) deployment is essential to inform policy decisions and monitor serotype replacement. We report serotype and disease severity trends in 3,719 adults hospitalized for pneumococcal disease in Bristol and Bath, United Kingdom, during 2006–2022. Of those cases, 1,686 were invasive pneumococcal disease (IPD); 1,501 (89.0%) had a known serotype. IPD decreased during the early COVID-19 pandemic but during 2022 gradually returned to prepandemic levels. Disease severity changed throughout this period: CURB65 severity scores and inpatient deaths decreased and ICU admissions increased. PCV7 and PCV13 serotype IPD decreased from 2006–2009 to 2021–2022. However, residual PCV13 serotype IPD remained, representing 21.7% of 2021–2022 cases, indicating that major adult PCV serotype disease still occurs despite 17 years of pediatric PCV use. Percentages of serotype 3 and 8 IPD increased, and 19F and 19A reemerged. In 2020–2022, a total of 68.2% IPD cases were potentially covered by PCV20.

Original language	English
Pages (from-to)	1953-1964
Number of pages	12
Journal	Emerging Infectious Diseases
Volume	29
Issue number	10
Early online date	14 Sept 2023
DOIs	https://doi.org/10.1101/2023.03.30.23287917 https://doi.org/10.3201/eid2910.230519
Publication status	Published - 1 Oct 2023

Bibliographical note

Funding Information:
We thank the research teams at The Royal United, North Bristol, and University Hospitals of Bristol and Weston National Health Service Trusts for participating in the study. Data used in this study are sensitive and cannot be made publicly available without breaching patient confidentiality rules. Therefore, individual participant data and a data dictionary are not available to other researchers.

Funding Information:
C.H. is principal investigator of the AvonCAP study, which is an investigator-led University of Bristol study supported by Pfizer. A.F. is a member of the Joint Committee on Vaccination and Immunization and was, until December 2022, chair of the World Health Organization European Technical Advisory Group of Experts on Immunization committee. In addition to receiving support from Pfizer as chief investigator of this study, he leads another project investigating transmission of respiratory bacteria in families jointly supported by Pfizer and the Gates Foundation. The other authors have no relevant conflicts of interest to declare.

Publisher Copyright:
© 2023 Centers for Disease Control and Prevention (CDC). All rights reserved.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Research Groups and Themes

Academic Respiratory Unit

Keywords

Adult
Humans
Serogroup
Patient Acuity
Pneumococcal Infections/epidemiology
United Kingdom/epidemiology

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Hyams, C., Challen, R. J., Hettle, D., Amin-Chowdhury, Z., Grimes, C., Ruffino, G., Conway, R., Heath, R., North, P., Malin, A. S., Maskell, N. A., Williams, P. B., Williams, O. M., Ladhani, S., Danon, L., & Finn, A. H. R. (2023). Serotype Distribution and Disease Severity in Adults Hospitalized with Streptococcus pneumoniae Infection, Bristol and Bath, UK, 2006‒2022. Emerging Infectious Diseases, 29(10), 1953-1964. https://doi.org/10.1101/2023.03.30.23287917, https://doi.org/10.3201/eid2910.230519

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title = "Serotype Distribution and Disease Severity in Adults Hospitalized with Streptococcus pneumoniae Infection, Bristol and Bath, UK, 2006‒2022",

abstract = "Ongoing surveillance after pneumococcal conjugate vaccination (PCV) deployment is essential to inform policy decisions and monitor serotype replacement. We report serotype and disease severity trends in 3,719 adults hospitalized for pneumococcal disease in Bristol and Bath, United Kingdom, during 2006–2022. Of those cases, 1,686 were invasive pneumococcal disease (IPD); 1,501 (89.0\%) had a known serotype. IPD decreased during the early COVID-19 pandemic but during 2022 gradually returned to prepandemic levels. Disease severity changed throughout this period: CURB65 severity scores and inpatient deaths decreased and ICU admissions increased. PCV7 and PCV13 serotype IPD decreased from 2006–2009 to 2021–2022. However, residual PCV13 serotype IPD remained, representing 21.7\% of 2021–2022 cases, indicating that major adult PCV serotype disease still occurs despite 17 years of pediatric PCV use. Percentages of serotype 3 and 8 IPD increased, and 19F and 19A reemerged. In 2020–2022, a total of 68.2\% IPD cases were potentially covered by PCV20.",

keywords = "Adult, Humans, Serogroup, Patient Acuity, Pneumococcal Infections/epidemiology, United Kingdom/epidemiology",

author = "Catherine Hyams and Challen, \{Robert J\} and David Hettle and Zahin Amin-Chowdhury and Charli Grimes and Gabriella Ruffino and Rauri Conway and Robyn Heath and Paul North and Malin, \{Adam S\} and Maskell, \{Nick A\} and Williams, \{Philip B\} and Williams, \{O Martin\} and Shamez Ladhani and Leon Danon and Finn, \{Adam H R\}",

note = "Funding Information: We thank the research teams at The Royal United, North Bristol, and University Hospitals of Bristol and Weston National Health Service Trusts for participating in the study. Data used in this study are sensitive and cannot be made publicly available without breaching patient confidentiality rules. Therefore, individual participant data and a data dictionary are not available to other researchers. Funding Information: C.H. is principal investigator of the AvonCAP study, which is an investigator-led University of Bristol study supported by Pfizer. A.F. is a member of the Joint Committee on Vaccination and Immunization and was, until December 2022, chair of the World Health Organization European Technical Advisory Group of Experts on Immunization committee. In addition to receiving support from Pfizer as chief investigator of this study, he leads another project investigating transmission of respiratory bacteria in families jointly supported by Pfizer and the Gates Foundation. The other authors have no relevant conflicts of interest to declare. Publisher Copyright: {\textcopyright} 2023 Centers for Disease Control and Prevention (CDC). All rights reserved.",

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Hyams, C , Challen, RJ, Hettle, D, Amin-Chowdhury, Z, Grimes, C, Ruffino, G, Conway, R, Heath, R, North, P, Malin, AS, Maskell, NA, Williams, PB, Williams, OM, Ladhani, S, Danon, L & Finn, AHR 2023, 'Serotype Distribution and Disease Severity in Adults Hospitalized with Streptococcus pneumoniae Infection, Bristol and Bath, UK, 2006‒2022', Emerging Infectious Diseases, vol. 29, no. 10, pp. 1953-1964. https://doi.org/10.1101/2023.03.30.23287917, https://doi.org/10.3201/eid2910.230519

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AU - Hyams, Catherine

AU - Challen, Robert J

AU - Hettle, David

AU - Amin-Chowdhury, Zahin

AU - Grimes, Charli

AU - Ruffino, Gabriella

AU - Conway, Rauri

AU - Heath, Robyn

AU - North, Paul

AU - Malin, Adam S

AU - Maskell, Nick A

AU - Williams, Philip B

AU - Williams, O Martin

AU - Ladhani, Shamez

AU - Danon, Leon

AU - Finn, Adam H R

N1 - Funding Information: We thank the research teams at The Royal United, North Bristol, and University Hospitals of Bristol and Weston National Health Service Trusts for participating in the study. Data used in this study are sensitive and cannot be made publicly available without breaching patient confidentiality rules. Therefore, individual participant data and a data dictionary are not available to other researchers. Funding Information: C.H. is principal investigator of the AvonCAP study, which is an investigator-led University of Bristol study supported by Pfizer. A.F. is a member of the Joint Committee on Vaccination and Immunization and was, until December 2022, chair of the World Health Organization European Technical Advisory Group of Experts on Immunization committee. In addition to receiving support from Pfizer as chief investigator of this study, he leads another project investigating transmission of respiratory bacteria in families jointly supported by Pfizer and the Gates Foundation. The other authors have no relevant conflicts of interest to declare. Publisher Copyright: © 2023 Centers for Disease Control and Prevention (CDC). All rights reserved.

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N2 - Ongoing surveillance after pneumococcal conjugate vaccination (PCV) deployment is essential to inform policy decisions and monitor serotype replacement. We report serotype and disease severity trends in 3,719 adults hospitalized for pneumococcal disease in Bristol and Bath, United Kingdom, during 2006–2022. Of those cases, 1,686 were invasive pneumococcal disease (IPD); 1,501 (89.0%) had a known serotype. IPD decreased during the early COVID-19 pandemic but during 2022 gradually returned to prepandemic levels. Disease severity changed throughout this period: CURB65 severity scores and inpatient deaths decreased and ICU admissions increased. PCV7 and PCV13 serotype IPD decreased from 2006–2009 to 2021–2022. However, residual PCV13 serotype IPD remained, representing 21.7% of 2021–2022 cases, indicating that major adult PCV serotype disease still occurs despite 17 years of pediatric PCV use. Percentages of serotype 3 and 8 IPD increased, and 19F and 19A reemerged. In 2020–2022, a total of 68.2% IPD cases were potentially covered by PCV20.

AB - Ongoing surveillance after pneumococcal conjugate vaccination (PCV) deployment is essential to inform policy decisions and monitor serotype replacement. We report serotype and disease severity trends in 3,719 adults hospitalized for pneumococcal disease in Bristol and Bath, United Kingdom, during 2006–2022. Of those cases, 1,686 were invasive pneumococcal disease (IPD); 1,501 (89.0%) had a known serotype. IPD decreased during the early COVID-19 pandemic but during 2022 gradually returned to prepandemic levels. Disease severity changed throughout this period: CURB65 severity scores and inpatient deaths decreased and ICU admissions increased. PCV7 and PCV13 serotype IPD decreased from 2006–2009 to 2021–2022. However, residual PCV13 serotype IPD remained, representing 21.7% of 2021–2022 cases, indicating that major adult PCV serotype disease still occurs despite 17 years of pediatric PCV use. Percentages of serotype 3 and 8 IPD increased, and 19F and 19A reemerged. In 2020–2022, a total of 68.2% IPD cases were potentially covered by PCV20.

KW - Adult

KW - Humans

KW - Serogroup

KW - Patient Acuity

KW - Pneumococcal Infections/epidemiology

KW - United Kingdom/epidemiology

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DO - 10.1101/2023.03.30.23287917

M3 - Article (Academic Journal)

C2 - 37735739

SN - 1080-6059

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SP - 1953

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JO - Emerging Infectious Diseases

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ER -

Serotype Distribution and Disease Severity in Adults Hospitalized with Streptococcus pneumoniae Infection, Bristol and Bath, UK, 2006‒2022

Abstract

Bibliographical note

UN SDGs

Research Groups and Themes

Keywords

Access to Document

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