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Volume 29, Number 10—October 2023
CME ACTIVITY - Synopsis

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

Catherine Hyams1Comments to Author , Robert Challen1, David Hettle, Zahin Amin-Chowdhury, Charli Grimes, Gabriella Ruffino, Rauri Conway, Robyn Heath, Paul North, Adam Malin, Nick A. Maskell, Philip Williams, O. Martin Williams, Shamez N. Ladhani, Leon Danon, and Adam Finn
Author affiliations: University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn); Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn); Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams); UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani); The Royal United Hospital, Bath, UK (A. Malin)

Main Article

Table 2

Case number and percentage of disease attributable to each pneumococcal serotype, by vaccine group, Bristol. UK, January 2021‒December 2022*

Vaccine and serotype 2006–2009
 2010–2015
 2016–2019
 2020
 2021–2022
Cases % (95% CI) Cases % (95% CI) Cases % (95% CI) Cases % (95% CI) Cases % (95% CI)
PCV7
Subtotal 73/248 29.4 (24.1‒35.4) 38/536 7.1 (5.2‒9.6) 8/534 1.5 (0.8‒2.9) 1/54 1.9 (0.3‒9.8) 9/129 7.0 (3.7‒12.7)
4 8/248 3.2 (1.6‒6.2) 5/536 0.9 (0.4‒2.2) 3/534 0.6 (0.2‒1.6) 0/54 0.0 (0.0‒6.6) 1/129 0.8 (0.1‒4.3)
6B 6/248 2.4 (1.1‒5.2) 4/536 0.7 (0.3‒1.9) 0/534 0.0 (0.0‒0.7) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
9V 8/248 3.2 (1.6‒6.2) 2/536 0.4 (0.1‒1.4) 0/534 0.0 (0.0‒0.7) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
14 25/248 10.1 (6.9‒14.5 6/536 1.1 (0.5‒2.4) 2/534 0.4 (0.1‒1.4) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
18C 5/248 2.0 (0.9‒4.6) 3/536 0.6 (0.2‒1.6) 0/534 0.0 (0.0‒0.7) 0/54 0.0 (0.0‒6.6) 1/129 0.8 (0.1‒4.3)
19F 8/248 3.2 (1.6‒6.2) 5/536 0.9 (0.4‒2.2) 3/534 0.6 (0.2‒1.6) 1/54 1.9 (0.3‒9.8) 6/129 4.7 (2.1‒9.8)
23F
 13/248
 5.2 (3.1‒8.8)
13/536
 2.4 (1.4‒4.1)
0/534
 0.0 (0.0‒0.7)
0/54
 0.0 (0.0‒6.6)
1/129
 0.8 (0.1‒4.3)
PCV13–7
Subtotal 85/248 34.3 (28.6‒40.4) 157/536 29.3 (25.6‒33.3) 105/534 19.7 (16.5‒23.2) 5/54 9.3 (4.0‒19.9) 28/129 21.7 (15.5‒29.6)
1 22/248 8.9 (5.9‒13.1) 30/536 5.6 (3.9‒7.9) 3/534 0.6 (0.2‒1.6) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
3 12/248 4.8 (2.8‒8.3) 43/536 8.0 (6.0‒10.6) 63/534 11.8 (9.3‒14.8) 4/54 7.4 (2.9‒17.6) 21/129 16.3 (10.9‒23.6)
6A 9/248 3.6 (1.9‒6.8) 1/536 0.2 (0.0‒1.0) 0/534 0.0 (0.0‒0.7) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
7F 22/248 8.9 (5.9‒13.1) 49/536 9.1 (7.0‒11.9) 10/534 1.9 (1.0‒3.4) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
19A
 20/248
 8.1 (5.3‒12.1)
34/536
 6.3 (4.6‒8.7)
29/534
 5.4 (3.8‒7.7)
1/54
 1.9 (0.3‒9.8)
7/129
 5.4 (2.7‒10.8)
PCV13
 158/248
 63.7 (57.6‒69.4)
195/536
 36.4 (32.4‒40.5)
113/534
 21.2 (17.9‒24.8)
6/54
 11.1 (5.2‒22.2)
37/129
 28.7 (21.6‒37.0)
Non-PCV13
 90/248
 36.3 (30.6‒42.4)
341/536
 63.6 (59.5‒67.6)
421/534
 78.8 (75.2‒82.1)
48/54
 88.9 (77.8‒94.8)
92/129
 71.3 (63.0‒78.4)
PCV15–13
Subtotal 29/248 11.7 (8.3‒16.3) 63/536 11.8 (9.3‒14.8) 62/534 11.6 (9.2‒14.6) 4/54 7.4 (2.9‒17.6) 8/129 6.2 (3.2‒11.8)
22F 17/248 6.9 (4.3‒10.7) 44/536 8.2 (6.2‒10.8) 42/534 7.9 (5.9‒10.5) 4/54 7.4 (2.9‒17.6) 8/129 6.2 (3.2‒11.8)
33F
 12/248
 4.8 (2.8‒8.3)
19/536
 3.5 (2.3‒5.5)
20/534
 3.7 (2.4‒5.7)
0/54
 0.0 (0.0‒6.6)
0/129
 0.0 (0.0‒2.9)
PCV15
 187/248
 75.4 (69.7‒80.3)
258/536
 48.1 (43.9‒52.4)
175/534
 32.8 (28.9‒36.9)
10/54
 18.5 (10.4‒30.8)
45/129
 34.9 (27.2‒43.4)
Non-PCV15
 61/248
 24.6 (19.7‒30.3)
278/536
 51.9 (47.6‒56.1)
359/534
 67.2 (63.1‒71.1)
44/54
 81.5 (69.2‒89.6)
84/129
 65.1 (56.6‒72.8)
PCV20–15
Subtotal 38/248 15.3 (11.4‒20.3) 133/536 24.8 (21.3‒28.6) 221/534 41.4 (37.3‒45.6) 17/54 31.5 (20.7‒44.7) 43/129 33.3 (25.8‒41.8)
8 18/248 7.3 (4.6‒11.2) 62/536 11.6 (9.1‒14.6) 113/534 21.2 (17.9‒24.8) 9/54 16.7 (9.0‒28.7) 33/129 25.6 (18.8‒33.7)
10A 0/248 0.0 (0.0‒1.5) 11/536 2.1 (1.1‒3.6) 19/534 3.6 (2.3‒5.5) 2/54 3.7 (1.0‒12.5) 2/129 1.6 (0.4‒5.5)
11A 6/248 2.4 (1.1‒5.2) 7/536 1.3 (0.6‒2.7) 23/534 4.3 (2.9‒6.4) 2/54 3.7 (1.0‒12.5) 4/129 3.1 (1.2‒7.7)
12F 10/248 4.0 (2.2‒7.3) 48/536 9.0 (6.8‒11.7) 57/534 10.7 (8.3‒13.6) 3/54 5.6 (1.9‒15.1) 3/129 2.3 (0.8‒6.6)
15B
 4/248
 1.6 (0.6‒4.1)
5/536
 0.9 (0.4‒2.2)
9/534
 1.7 (0.9‒3.2)
1/54
 1.9 (0.3‒9.8)
1/129
 0.8 (0.1‒4.3)
PCV20–13
 67/248
 27.0 (21.9‒32.9)
196/536
 36.6 (32.6‒40.7)
283/534
 53.0 (48.8‒57.2)
21/54
 38.9 (27.0‒52.2)
51/129
 39.5 ([31.5‒48.2)
PCV20
 225/248
 90.7 (86.5‒93.7)
391/536
 72.9 (69.0‒76.5)
396/534
 74.2 (70.3‒77.7)
27/54
 50.0 (37.1‒62.9)
88/129
 68.2 (59.8‒75.6)
Non-PCV 23/248 9.3 (6.3‒13.5) 145/536 27.1 (23.5‒31.0) 138/534 25.8 (22.3‒29.7) 27/54 50.0 (37.1‒62.9) 41/129 31.8 (24.4‒40.2)
2 0/248 0.0 (0.0‒1.5) 0/536 0.0 (0.0‒0.7) 1/534 0.2 (0.0‒1.1) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
9N 5/248 2.0 (0.9‒4.6) 20/536 3.7 (2.4‒5.7) 27/534 5.1 (3.5‒7.3) 3/54 5.6 (1.9‒15.1) 10/129 7.8 (4.3‒13.7)
17F 0/248 0.0 (0.0‒1.5) 0/536 0.0 (0.0‒0.7) 6/534 1.1 (0.5‒2.4) 0/54 0.0 (0.0‒6.6) 2/129 1.6 (0.4‒5.5)
20 1/248 0.4 (0.1‒2.2) 4/536 0.7 (0.3‒1.9) 9/534 1.7 (0.9‒3.2) 4/54 7.4 (2.9‒17.6) 4/129 3.1 (1.2‒7.7)
6C 2/248 0.8 (0.2‒2.9) 23/536 4.3 (2.9‒6.4) 3/534 0.6 (0.2‒1.6) 1/54 1.9 (0.3‒9.8) 1/129 0.8 (0.1‒4.3)
7C 0/248 0.0 (0.0‒1.5) 0/536 0.0 (0.0‒0.7) 5/534 0.9 (0.4‒2.2) 1/54 1.9 (0.3‒9.8) 5/129 3.9 (1.7‒8.8)
10B 0/248 0.0 (0.0‒1.5) 0/536 0.0 (0.0‒0.7) 2/534 0.4 (0.1‒1.4) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
12B 0/248 0.0 (0.0‒1.5) 3/536 0.6 (0.2‒1.6) 0/534 0.0 (0.0‒0.7) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
13 0/248 0.0 (0.0‒1.5) 1/536 0.2 (0.0‒1.0) 1/534 0.2 (0.0‒1.1) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
15A 2/248 0.8 (0.2‒2.9) 24/536 4.5 (3.0‒6.6) 20/534 3.7 (2.4‒5.7) 2/54 3.7 (1.0‒12.5) 5/129 3.9 (1.7‒8.8)
15C 3/248 1.2 (0.4‒3.5) 2/536 0.4 (0.1‒1.4) 1/534 0.2 (0.0‒1.1) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
16F 2/248 0.8 (0.2‒2.9) 8/536 1.5 (0.8‒2.9) 11/534 2.1 (1.2‒3.7) 4/54 7.4 (2.9‒17.6) 1/129 0.8 (0.1‒4.3)
18A 0/248 0.0 (0.0‒1.5) 0/536 0.0 (0.0‒0.7) 1/534 0.2 (0.0‒1.1) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
21 0/248 0.0 (0.0‒1.5) 1/536 0.2 (0.0‒1.0) 1/534 0.2 (0.0‒1.1) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
22A 1/248 0.4 (0.1‒2.2) 0/536 0.0 (0.0‒0.7) 1/534 0.2 (0.0‒1.1) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
23A 1/248 0.4 (0.1‒2.2) 14/536 2.6 (1.6‒4.3) 8/534 1.5 (0.8‒2.9) 2/54 3.7 (1.0‒12.5) 6/129 4.7 (2.1‒9.8)
23B 0/248 0.0 (0.0‒1.5) 11/536 2.1 (1.1‒3.6) 6/534 1.1 (0.5‒2.4) 3/54 5.6 (1.9‒15.1) 2/129 1.6 (0.4‒5.5)
24 0/248 0.0 (0.0‒1.5) 0/536 0.0 (0.0‒0.7) 1/534 0.2 (0.0‒1.1) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
24F 0/248 0.0 (0.0‒1.5) 6/536 1.1 (0.5‒2.4) 9/534 1.7 (0.9‒3.2) 1/54 1.9 (0.3‒9.8) 1/129 0.8 (0.1‒4.3)
27 0/248 0.0 (0.0‒1.5) 0/536 0.0 (0.0‒0.7) 2/534 0.4 (0.1‒1.4) 0/54 0.0 (0.0—6.6) 1/129 0.8 (0.1‒4.3)
28A 0/248 0.0 (0.0‒1.5) 0/536 0.0 (0.0‒0.7) 0/534 0.0 (0.0‒0.7) 1/54 1.9 (0.3—9.8) 0/129 0.0 (0.0‒2.9)
31 3/248 1.2 (0.4‒3.5) 1/536 0.2 (0.0‒1.0) 2/534 0.4 (0.1‒1.4) 1/54 1.9 (0.3—9.8) 0/129 0.0 (0.0‒2.9)
32B 0/248 0.0 (0.0‒1.5) 1/536 0.2 (0.0‒1.0) 1/534 0.2 (0.0‒1.1) 0/54 0.0 (0.0—6.6) 0/129 0.0 (0.0‒2.9)
33D 0/248 0.0 (0.0‒1.5) 0/536 0.0 (0.0‒0.7) 2/534 0.4 (0.1‒1.4) 0/54 0.0 (0.0—6.6) 0/129 0.0 (0.0‒2.9)
34 0/248 0.0 (0.0‒1.5) 0/536 0.0 (0.0‒0.7) 2/534 0.4 (0.1‒1.4) 0/54 0.0 (0.0—6.6) 0/129 0.0 (0.0‒2.9)
35B 1/248 0.4 (0.1‒2.2) 8/536 1.5 (0.8‒2.9) 11/534 2.1 (1.2‒3.7) 1/54 1.9 (0.3—9.8) 2/129 1.6 (0.4‒5.5)
35C 0/248 0.0 (0.0‒1.5) 2/536 0.4 (0.1‒1.4) 0/534 0.0 (0.0‒0.7) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)
35F 0/248 0.0 (0.0‒1.5) 10/536 1.9 (1.0‒3.4) 3/534 0.6 (0.2‒1.6) 2/54 3.7 (1.0‒12.5) 1/129 0.8 (0.1‒4.3)
37 0/248 0.0 (0.0‒1.5) 1/536 0.2 (0.0‒1.0) 0/534 0.0 (0.0‒0.7) 1/54 1.9 (0.3‒9.8) 0/129 0.0 (0.0‒2.9)
38 2/248 0.8 (0.2‒2.9) 5/536 0.9 (0.4‒2.2) 2/534 0.4 (0.1‒1.4) 0/54 0.0 (0.0‒6.6) 0/129 0.0 (0.0‒2.9)

*Values are no. positive/no. tested except as indicated. PCV, pneumococcal conjugate vaccination.

Main Article

1These authors contributed equally to this article.

Page created: July 31, 2023
Page updated: September 15, 2023
Page reviewed: September 15, 2023
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