Recurrent Pneumococcal Community-Acquired Pneumonia in Hospitalised Patients

Abstract

Recurrent pneumococcal CAP refers to episodes of pneumococcal CAP that occur at least 30 days apart, constituting 60% of recurrent invasive pneumococcal diseases. HIV increases the risk of severe pneumococcal CAP. Given South Africa's high HIV prevalence, understanding the burden and vaccine preventability of recurrent pneumococcal CAP is crucial. The objective was to investigate the incidence of recurrent pneumococcal CAP, identify causal serotypes, and evaluate mortality among hospitalised patients with pneumococcal CAP. We retrospectively collected data from 1573 patients hospitalised with pneumococcal CAP at three hospitals between 2019 and 2021, including a 1-year follow-up period. Among 1573 patients, there were 63 episodes of recurrent pneumococcal CAP in 27 (1.72%) patients. The incidence was 18.53 per 1000 person-years with IRR=0.925 [95% CI: (0.608-1.352)]. Of the 27 patients with recurrent pneumococcal CAP, 19 (70%) were PLWH, OR=2.06 [ p=0.0598; 95% CI (0.854- 5.47)]. PCV13 and PPSV23 causal serotypes were 54% and 88% respectively. In conclusion, at least 19 of 1000 pneumococcal CAP hospitalised patients will have vaccine preventable recurrent pneumococcal CAP within 1-year.