Residents living near goat farms (< 2000 m) in the Netherlands have consistently shown an elevated risk of pneumonia, yet the pathogens underlying this association remain unknown. This study assessed the presence of 33 respiratory pathogens, including bacteria, viruses, and fungi, across rural populations with different goat farm exposures. This cross-sectional study included general practitioner (GP)-diagnosed pneumonia patients (PP; n = 108), non-farming rural residents without pneumonia (NFR; n = 200), and goat farm workers (GFW; n = 91). Oropharyngeal and nasopharyngeal swabs were collected and analyzed by a multiplex and two additional PCR test targeting in total 12 bacteria, 20 viruses and 1 fungus. Between-group differences in detection were assessed by Fisher’s exact tests. Logistic regression analyses were performed to assess associations between pathogen detection and residential proximity to goat farming and other covariates. Presence of any of the examined pathogens was highest in the PP group (94.5
Abstract Background Pneumococcal disease (PD) is a leading cause of morbidity among US children, particularly those with chronic medical conditions (CMC) and immunocompromising conditions (IC), and the decline in PD incidence was less pronounced in the late pneumococcal conjugate vaccine (PCV) 13 period. This study quantified healthcare resource utilization (HCRU) and costs among commercially and Medicaid-insured children with PD. Methods This retrospective observational cohort study used Merative™ MarketScan® Commercial Database and Multi-State Medicaid Databases to identify children with invasive pneumococcal disease (IPD), all-cause pneumonia (ACP), and acute otitis media (AOM) episodes using inpatient and outpatient claims. HCRU and costs per PD episode were assessed in the commercially and Medicaid-insured populations, stratified by age (<2, 2-4, and 5-17 years) and risk group (CMC, IC, and no CMC/IC). Results Between 2018 and 2023, commercially insured children contributed 23.6 million person-years (PY) and Medicaid-insured children contributed 23.4 million PY; 423 and 664 children had IPD, 309,540 and 281,569 had ACP, and 2,721,354 and 2,596,201 had AOM in the commercial and Medicaid populations, respectively. In both databases, HCRU and cost was higher in children with CMC or IC, compared to no CMC/IC across age groups for all PD manifestations. For IPD and ACP, inpatient admissions were 1.4 to 2.2-fold longer for children with CMC or IC. For IPD, costs per episode were 2-to-3-fold higher in children with CMC or IC, compared with those without CMC/IC (Commercial: $76,278 and $72,130 vs. $22,371; Medicaid: $17,389 and $19,945 vs. $6,476, respectively). For ACP, costs were highest in children with IC, followed by CMC and no CMC/IC (Commercial: $7,343, $2,637, and $809; Medicaid: $3,257, $1,160, and $356, respectively). AOM showed a similar pattern, with highest costs in children with IC (Commercial: $608; Medicaid: $178), followed by CMC ($442; $141), and lowest in those without CMC/IC ($368; $123). Conclusions US children with underlying conditions that increase susceptibility to PD experience substantially higher HCRU and costs compared with those without such conditions, across all PD manifestations, regardless of insurance type and age group. These findings underscore the need for risk-based prevention strategies, including vaccination, beyond early childhood in high-risk pediatric populations.
Streptococcus pneumoniae is a leading cause of community-acquired pneumonia (CAP) in adults, yet microbiological diagnosis remains challenging. Quantitative lytA-PCR on nasopharyngeal samples has improved diagnostic yield; however, a substantial proportion of patients with confirmed pneumococcal pneumonia (PPn) remain lytA-negative. We hypothesized that nasopharyngeal microbiota profiles differ according to lytA-PCR status on nasopharynx and may reflect distinct pathogenetic pathways. We conducted a prospective, observational study including adults hospitalized with confirmed PPn. Nasopharyngeal samples were collected before initiation of antimicrobial therapy for lytA-PCR quantification and 16S rRNA gene sequencing. Patients were stratified according to nasopharyngeal lytA-PCR status. Microbiota diversity and composition were analysed at the genus and amplicon sequence variant (ASV) levels. Differential abundance was assessed using ALDEx2, and associations between pneumococcal load and Streptococcus ASVs were explored. Among 38 patients, 24 (63
The main burden of non-invasive pneumococcal diseases in adults is largely due to community-acquired pneumonia (CAP). This study aimed to investigate the distribution and dynamics of pneumococcal vaccine serotypes and to determine the proportion of CAP cases attributable to serotypes covered by 13-valent conjugate vaccine (PCV13), the 20-valent conjugate vaccine (PCV20), and the 23-valent polysaccharide vaccine (PPV23) among adults in Germany from 2020 to 2023. In this prospective multicenter cohort study, we analyzed all adult patients with CAP enrolled between January 1, 2020, and December 31, 2023, at 26 centers in Germany who provided urine samples for serotype-specific urine antigen detection (SSUAD) testing. Annual trends of pneumococcal vaccine serotypes from 2020 to 2023 were calculated for all patients and patient groups at risk using cluster-robust generalized linear models with heteroscedasticity-consistent standard errors. Of the 2,028 patients with all-cause CAP, 1,504 (1,008 patients aged ≥ 60 years, 373 younger patients with at least one comorbidity) had urine samples analyzed with SSUAD tests. Overall proportion of vaccine-type pneumococcal pneumonia among all-cause CAP for PCV13, PCV20, and PPV23 serotypes was 5.41
CURB-65 score usefulness has been assessed in COVID-19 pneumonia, but not in cohorts including immunocompromised patients. SARS-CoV-2 RNAemia is associated with mortality and unfavorable clinical outcomes in COVID-19. This study aimed to develop the VIRA score (Viremia-Integrated Risk Assessment), incorporating CURB-65 and RNAemia, for predicting 30-day COVID-19 pneumonia mortality. We included two multicenter cohorts of COVID-19 pneumonia: 539 immunocompetent and 280 immunocompromised patients, vaccinated against SARS-CoV-2 in 191 (35.4
