title: Prospective, population-based surveillance of the burden of Streptococcus pneumoniae in community-acquired pneumonia in older adults, Chrzanów County, Poland, 2010 to 2012.
abstract: BACKGROUND
  Community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae is a substantial cause of morbidity and mortality among older adults. This study estimated incidences of CAP, chest x-ray-confirmed CAP (CXR+CAP), S pneumonia- positive CAP, S pneumonia-positive CXR+CAP, and S. pneumoniae serotype distribution among 46,000 at-risk adults aged ≥ 50 years residing in Chrzanów County, Poland.
  
  
  METHODS
  From January 2010 to January 2012, all facilities providing ambulatory and inpatient care enrolled all consenting resident patients with suspicion of CAP. Chest x-rays, urine, blood, and sputum samples were analyzed. Annualized incidence rates were determined. Presence of S pneumonia-positive CAP and/or S. pneumoniae serotype distribution was determined using the urine antigen detection assay (capable of detecting the serotypes in the 13-valent pneumococcal conjugate vaccine [PCV13]), BinaxNOW®, and/or microbiology cultures.
  
  
  RESULTS
  Among 5055 enrolled patients, 1195 (23.7%) were diagnosed with CAP and 1166 (23.4%) had CXR+CAP. S. pneumoniae was detected in 144 (12.1%) and 131 (11.2%) patients from the CAP and CXR+CAP cohorts, respectively. Annualized incidence rates of CAP, CXR+CAP, S pneumonia-positive CAP, and S. pneumonia-positive CXR+CAP were 12.8, 12.5, 1.6, and 1.4 per 1000 residents, respectively. Among CXR+CAP patients, 39.7% were aged 50 to 64 years and 60.3% were aged ≥ 65 years. Incidence rates generally increased with age. The most common serotypes in S. pneumoniae-positive CXR+CAP patients were 3 (n = 15), 23F (n = 10), 18C (n = 9), and 9V (n = 6).
  
  
  CONCLUSIONS
  CAP due to PCV13 serotypes is a source of morbidity among adults >50 years and may be reduced by greater access to pneumococcal vaccines.
authors.forename: Rafal
authors.initials: R
authors.lastname: Harat
authors.affiliation: Pfizer Inc, Collegeville, PA, USA. Ronika.Alexander@pfizer.com.
authors.forename: Ronika
authors.initials: R
authors.lastname: Alexander
authors.forename: Sharon
authors.initials: S
authors.lastname: Gray
authors.forename: Elane M
authors.initials: EM
authors.lastname: Gutterman
authors.forename: Justyna
authors.initials: J
authors.lastname: Pluta
authors.forename: Michael
authors.initials: M
authors.lastname: Pride
authors.forename: Sebastian
authors.initials: S
authors.lastname: Shite
authors.forename: Joanna
authors.initials: J
authors.lastname: Fijolek
authors.forename: Jolanta
authors.initials: J
authors.lastname: Kozub
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D017281:Cost of Illness; D005260:Female; D006801:Humans; D015994:Incidence; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D011044:Poland / Q000453:epidemiology; D011159:Population Surveillance; D011446:Prospective Studies; D011859:Radiography; D065288:Serogroup; D013183:Sputum / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D014556:Urine / Q000382:microbiology
keywords: CAP incidence; Poland; Streptococcus pneumoniae; adults; community-acquired pneumonia