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.
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Authors Michaela Tinggaard, Hans‐Christian Slotved, Randi Føns Petersen, Nichlas Hovmand, Thomas Benfield
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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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