LATE-BREAKING ABSTRACT: Differences inS. pneumoniaeserotypes distribution causing CAP in hospitalized adults in Spain according to comorbidities by a new urinary antigen detection (UAD) test. The CAPA study

Abstract

Background and objective: The presence of underlying conditions increases the risk of CAP. The 13-valent pneumococcal conjugate vaccine (PCV13) has demonstrated efficacy in the prevention of pneumococcal pneumonia and invasive pneumococcal disease in adults. In order to assess the burden of CAP, including non-bacteremic CAP, due to PCV13 serotypes (St), we explored differences in the distribution of PCV13 St in immunocompetent patients >18 years hospitalized in 3 Spanish hospitals (November 2011-June 2014) by presence of underlying conditions. Methods: In subjects hospitalized with chest X-ray confirmed CAP, microbiological confirmation was sought by the novel UAD assay (Pfizer9s PCV13 serotype specific urinary antigen detection test), BinaxNOW & conventional cultures. Serotyping of pneumococcal isolates was accomplished in a central laboratory using Quellung reaction. Results: S. pneumoniae CAP was confirmed in 351 (29.8%) of 1179 included patients. Underlying conditions and/or risk habits were present in 87.4% of patients (mean age 67.7±17.9). Below table shows PCV13 St distribution in CAP by presence of specific underlying conditions according to UAD test results. Conclusion: Among at risk adults with chronic diseases, more than 50% of pneumococcal CAP cases were due to PCV13 serotypes.