Study demonstrates a substantial burden of potentially preventable hospitalizations for pneumococcal pneumonias among adults in Tennessee and Georgia

In a recent multicenter prospective study conducted at three hospitals in Tennessee and Georgia, including Vanderbilt University Medical Center, researchers at VUMC found a substantial burden of hospitalizations for community-acquired pneumonia (CAP) among adults. 

Community-acquired pneumonia refers to a case of the disease contracted without prior exposure to a health care setting. This distinguishes CAP from hospital-acquired pneumonia (HAP), which affects patients who contract the disease as a result of exposure to a health care setting. 

The study, published in JAMA Network Open, included data from 2018 to 2022 and used a novel serotype-specific urinary test that can identify infections caused by 30 different Streptococcus pneumoniae serotypes. A serotype refers to a distinct strain of microorganism, such as bacteria. 

An important aspect of the study was the identification of noninvasive pneumococcal infections, said Carlos Grijalva, MD, MPH, professor of Health Policy and Biomedical Informatics and the study’s lead author. 

“Standard clinical diagnostic methods such as bacterial cultures of blood are helpful for identifying invasive cases of pneumococcal disease, but the majority of pneumococcal pneumonias are thought to be noninvasive,” Grijalva added. “Using a novel and more sensitive urinary antigen detection method allowed us to identify a number of pneumococcal infections that may have otherwise passed unrecognized.” 

Based on current population estimates, some 114,800 U.S. adults may be hospitalized for pneumococcal pneumonia each year, a figure made up in large part by older adults. And according to the study’s findings, each year sees approximately 340 hospitalizations for community-acquired pneumonia per 100,000 adults, approximately 14% of which had evidence of Streptococcus pneumoniae infection. 

“Our study results show that Streptococcus pneumoniae remains an important cause of severe community-acquired pneumonia,” said Wesley Self, MD, MPH, professor of Emergency Medicine, Senior Vice President for Clinical Research and the paper’s senior author. 

Many of the serotypes identified by pneumococcal detections corresponded with those covered by a recently licensed adult-specific pneumococcal conjugate vaccine, V116, which includes 21 serotypes but was not commercially available during the study period. 

“Vaccines with coverage of additional pneumococcal serotypes could be quite beneficial in lessening the burden of severe pneumonia on the U.S. population, especially among older adults,” added Self, who holds the Directorship in Emergency Care Research. 

The research was spearheaded by VUMC’s PNEUMO program, short for the Pneumococcal Pneumonia Epidemiology, Urine Serotyping, and Mental Outcomes Study. VUMC participated in the research alongside Emory University Hospital and Emory University Hospital Midtown, both in Atlanta. 

The study was funded by Merck Sharp & Dohme LLC.