Prevalence, serotype distribution and risk factors associated with Streptococcus pneumoniae carriage in older adults in Denmark, 2019-2022

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ID: 322441
2026
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Abstract
Abstract Background The burden of pneumococcal disease in older adults remain high in the post pneumococcal conjugate vaccine (PCV) era. We hypothesized that older adults may represent a carriage reservoir of Streptococcus pneumoniae. Methods Paired naso- and oropharyngeal (NP and OP) swabs and questionnaires were collected during 2019-2022 from adults ≥ 65 years of age. Pneumococcal carriage and serotype distribution were determined by phenotypical and molecular methods. Results A total of 172/1764 participants (9.8% (95% CI 8.4-11.2)) were positive for carriage of Streptococcus pneumoniae by either culture (0.3%) or lytA/piaB DNA in NP (2.0%) or OP (8.4%) samples. Overall, 118 serogroup- or serotype-specific carriage events were identified by multiplex PCR across 16 distinct serospecificities in 93 samples, while 79 samples were non-typeable. PCV13 types accounted for 8.0%, non-vaccine types for 11.0% and polysaccharide pneumococcal vaccine 23 (PPV23)/non-PCV13 types for 81.0%. All carriage serotypes, except serotype 2, had been identified in IPD isolates among adults ≥ 65 years during 2019-2022. Having young grandchildren was associated with increased odds of carriage (adjusted OR 1.8, 95% CI 1.2-2.5, p=0.0031). No association between PPV23 immunization and carriage was observed (OR 0.8, 95% CI 0.5-1.3). Conclusion Older adults were carriers of a wide range of IPD causing serotypes. Both carriage and IPD serotypes were mainly comprised of non-PCV13 serotypes. Immunization with higher valency conjugated vaccines is likely required to reduce residual pneumococcal disease among older adults.
Reference Key
openalex_W7170955752 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Michaela Tinggaard, Hans‐Christian Slotved, Randi Føns Petersen, Nichlas Hovmand, Thomas Benfield
Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag452
URL
https://doi.org/10.1093/ofid/ofag452
Keywords Keywords not found

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