Background:Understanding the prevalence of pneumococcal serotypes in hospitalised patients with community-acquired pneumonia (CAP) is critical for vaccine development and implementation of future public health policies. Pneumococcal conjugate vaccines (PCVs) have been implemented to decrease the burden of pneumococcal disease. This study aims to identify the serotype distribution of pneumococcal CAP in Germany. Methods:This interim analysis of a multicentre, prospective, active observational study includes patients aged ≥18 years hospitalised with CAP in seven German hospitals. Patients were enrolled between August 2022 and September 2024. To determine CAP aetiology, microbiological tests were performed according to local standard of care. Urinary antigen testing for Streptococcus pneumoniae (BinaxNOW) was performed in all patients, and two serotype-specific urinary antigen detection (SSUAD) assays were used to detect serotypes in pneumococcal vaccines PCV15 and PCV20. Results:S. pneumoniae was detected in 16.5% (85/514) of participants by all diagnostic tests. SSUAD assays detected S. pneumoniae as pathogen in 13.2% (68/514) of participants. In six patients, two pneumococcal serotypes were detected. The seven most detected serotypes were: 3, 11A, 8, 23B, 9N, 18C and 22F. Among 74 serotype detections, 64 (86.9%) are included in V116 compared with 56 (75.8%) in PCV20. The difference in coverage between PCV20 and V116 was 10.8% (95% CI -3.2-24.8%). Conclusion:Among adults hospitalised with CAP in Germany, S. pneumoniae was detected in 13% of cases by SSUAD assays. While the findings suggest that V116 may offer broader serotype coverage compared with PCV20, these differences were not statistically significant.
Background Developmental dysplasia of the hip (DDH) is among the most common congenital musculoskeletal disorders and may lead to early hip osteoarthritis if left untreated. Modified Pemberton acetabuloplasty is an established, growth-preserving osteotomy technique for surgical correction in childhood. However, robust clinical long-term outcomes with follow-up periods exceeding two decades have not yet been published. The aim of this study was to retrospectively evaluate functional and patient-reported outcomes after an average follow-up of 25.6 years. Methods In this monocentric retrospective cohort study, 63 patients (92 hips) were included from an original cohort of 331 patients with 507 operated hips who had undergone modified Pemberton acetabuloplasty between 1990 and 1995. In 2018, clinical follow-up was performed in 54 patients; all participants completed standardised questionnaires, including the Harris Hip Score (HHS), WOMAC, and EQ-5D. Data analysis was descriptive. Results The mean follow-up period was 25.6 years. The average HHS was 95.8 points, the mean WOMAC index 7.2 points, and the EQ-5D-VAS 89.3/100. A total of 81% of patients were free of symptoms, and 83.3% achieved excellent functional results. Overall, 96.8% rated the surgical outcome as good or very good, and 92% would choose to undergo the procedure again. No patient required total hip arthroplasty. No major postoperative complications occurred. Conclusion Modified Pemberton acetabuloplasty demonstrates stable functional outcomes, low symptom levels, and high health-related quality of life more than 25 years after surgery. The very high patient satisfaction and the absence of secondary procedures underscore the long-term clinical effectiveness of this growth-preserving technique.
