Burden of Community-Acquired Pneumonia due to PCV-13 Streptococcus pneumoniae Serotypes Among Hospitalized Adults in the United States

BACKGROUND: The burden of disease for US adult patients hospitalized with community-acquired pneumonia (CAP) due to S. pneumoniae (Sp) PCV13 vaccine types (VT) is not known. The objective of this study was to determine the incidence, patients’ characteristics, length of stay and mortality for US adults hospitalized with CAP due to Sp-PCV13VT. METHODS: This was a prospective observational study of adults hospitalized between October 7, 2013 and September 30, 2016 with radiographically confirmed CAP in 19 centers in the US. Patients were included if the following 5 criteria were met: 1) Age 18 years and older; 2) Presence of two or more of the following: fever, hypothermia, chills or rigors, pleuritic chest pain, cough, sputum production, dyspnea, tachypnea, malaise, and abnormal auscultatory findings suggestive of pneumonia; 3) Radiographic finding consistent with pneumonia; 4) Able to provide urine sample; 5) Signed informed consent. The presence of Sp-PCV13VT was investigated using a Luminex-based urinary antigen detection (UAD) assay or serotyping from a positive Sp isolate. Data on patients’ characteristics, length of stay (LOS) and in-hospital mortality (IHM) were collected. RESULTS: From a total of 12,055 hospitalized patients with CAP, VT Sp-PCV13 was detected in 552 patients via UAD or culture (4.6%). Among patients hospitalized with CAP due to Sp-PCV13VT, median age was 64 years, and the most common comorbidities were chronic obstructive pulmonary disease (46.2%) and diabetes (27.3%). Median LOS was 6 days, and IHM was 5.4%. There were no clinically significant differences when this population was compared with the population of patients with non-PCV13 VT Sp-CAP. CONCLUSION: In approximately 5% of US adults hospitalized with CAP, the etiologic agent is VT Sp-PCV13. Clinical characteristics and outcomes in this population were similar when compared with the general population of hospitalized patients with CAP. In conclusion, this study indicates a persistent burden of disease for adult patients hospitalized with CAP due to vaccine preventable Sp serotypes. DISCLOSURES: All authors: No reported disclosures.