{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T15:54:49Z","timestamp":1783612489436,"version":"3.55.0"},"reference-count":48,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,4,15]],"date-time":"2022-04-15T00:00:00Z","timestamp":1649980800000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Pfizer, S\u00e3o Paulo, Brazil","award":["Grant WI219729"],"award-info":[{"award-number":["Grant WI219729"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,3,30]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the incidence, aetiology and pneumococcal serotype distribution of community-acquired pneumonia (CAP) in Brazilian adults during a 2-year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective population-based surveillance study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Patients from two emergency hospitals in Brazil were consecutively included in this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 111 adults aged 50 years and older with radiographically-confirmed CAP requiring an emergency department visit were prospectively enrolled between January 2018 and January 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Incidence rates of CAP were calculated according to age and pathogen. Pathogens were identified by conventional microbiological methods. Additionally, a novel, Luminex-based serotype specific urinary antigen detection assay was used to detect serotypes included in pneumococcal vaccines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean age of participants was 64 years and 31% were aged \u226570 years. Aetiology was established in 61 (57%) patients; among identified cases, the most common pathogens were\n                      <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      (42\/61, 69%) and influenza (4\/61, 7%). Among serotypes identified from the 42 cases of pneumococcal CAP, estimated coverage ranged by pneumococcal vaccine formulations from 47.6% (13-valent), 59.5% (20-valent, licenced in the USA only) and 71.4% (23-valent). In patients with CAP, 20-valent pneumococcal vaccine serotypes were identified 2.5 times more frequently than 10-valent pneumococcal vaccine serotypes (22.5% vs 9.0%). The incidence rate for CAP in adults aged \u226550 years was 20.1 per 10\u2009000 person-years. In general, the incidence of CAP increased consistently with age, reaching 54.4 (95% CI 36.8 to \u221276.6) per 10\u2009000 in adults 80 years or older.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We observed a high burden of pneumococcal CAP among adults in Brazil. Despite the routine immunisation of children and high-risk adults against pneumococcal disease in the Brazilian national vaccination programme, a persistent burden of pneumococcal CAP caused by vaccine serotypes remains in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-059824","type":"journal-article","created":{"date-parts":[[2022,4,15]],"date-time":"2022-04-15T11:32:40Z","timestamp":1650022360000},"page":"e059824","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Incidence, aetiology and serotype coverage for pneumococcal vaccines of community-acquired pneumonia in adults: a population-based prospective active surveillance study in Brazil"],"prefix":"10.1136","volume":"12","author":[{"given":"Fernanda Gross","family":"Duarte","sequence":"first","affiliation":[{"name":"Gon\u00e7alo Moniz Institute, Oswaldo Cruz Foundation, Brazilian Ministry of Health, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Goreth","family":"Barberino","sequence":"additional","affiliation":[{"name":"Gon\u00e7alo Moniz Institute, Oswaldo Cruz Foundation, Brazilian Ministry of Health, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"da Silva Moreira","sequence":"additional","affiliation":[{"name":"Centro de Pesquisa Cl\u00ednica (CPEC), Obras Sociais Irma Dulce, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joice Neves","family":"Reis","sequence":"additional","affiliation":[{"name":"Federal University of Bahia, Salvador, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Regazzini","family":"Spinardi","sequence":"additional","affiliation":[{"name":"Pfizer Brasil, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo Sini","family":"de Almeida","sequence":"additional","affiliation":[{"name":"Pfizer Inc, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen E","family":"Allen","sequence":"additional","affiliation":[{"name":"Pfizer Inc Pennsylvania, Collegeville, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronika","family":"Alexander-Parrish","sequence":"additional","affiliation":[{"name":"Pfizer Inc Pennsylvania, Collegeville, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Brim","sequence":"additional","affiliation":[{"name":"Federal University of Bahia, Salvador, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar Augusto","family":"de Ara\u00fajo Neto","sequence":"additional","affiliation":[{"name":"Federal University of Bahia, Salvador, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7081-8348","authenticated-orcid":false,"given":"Edson Duarte","family":"Moreira","sequence":"additional","affiliation":[{"name":"Gon\u00e7alo Moniz Institute, Oswaldo Cruz Foundation, Brazilian Ministry of Health, Salvador, Bahia, Brazil"},{"name":"Centro de Pesquisa Cl\u00ednica (CPEC), Obras Sociais Irma Dulce, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,4,15]]},"reference":[{"key":"2025121509465980000_12.4.e059824.1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(16)31678-6"},{"key":"2025121509465980000_12.4.e059824.2","unstructured":"Pneumonia in Children Statistics - UNICEF DATA. 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