{"doi":"10.1093/ofid/ofaf774","title":"Acute Respiratory Infections Due to Antibiotic-nonsusceptible <i>Streptococcus pneumoniae</i> in US Adults","abstract":"Background: (pneumococcus) in US adults (aged ≥18 years). Methods: We estimated antibiotic-nonsusceptible pneumococcal sinusitis and nonbacteremic pneumonia incidence as products of pneumococcal pneumonia and sinusitis incidence rates, serotype distribution, and serotype-specific antimicrobial nonsusceptibility prevalences from 2016 through 2019. Nonsusceptibility was considered by antibiotic class and guideline-recommended agents. We estimated pneumonia and sinusitis incidence rates from national surveys and administrative datasets and derived pneumococcal-attributable percents and serotype distributions from published data. Serotype-specific nonsusceptibility estimates were from Active Bacterial Core surveillance data. We evaluated nonsusceptibility for all serotypes and those targeted by 15-, 20-, and 21-valent pneumococcal conjugate vaccines (PCV15/20/21). Results: An estimated 16.4% (95% confidence interval, 12.8-21.4) of nonbacteremic pneumococcal pneumonia and 19.0% (14.8-24.9%) of sinusitis cases were nonsusceptible to ≥ 3 antibiotic classes, translating to 243 521 (179 673-333 675) and 1 844 726 (1 070 763-2 904 089) outpatient visits for pneumonia and sinusitis, respectively, and 10 155 (7542-13 803) pneumonia hospitalizations annually. An estimated 31.2% (26.6%-36.3%) of nonbacteremic pneumococcal pneumonia and 10.5% (9.4%-12.0%) of pneumococcal sinusitis cases were nonsusceptible to ≥ 1 outpatient first-line antibiotic agent. Cases attributable to serotypes targeted by PCV15, PCV20, and PCV21 that were nonsusceptible to ≥3 antibiotic classes accounted for 7.4% (4.7%-11.1%), 8.5% (5.8-12.1%), and 12.6% (9.2-17.5%) of nonbacteremic pneumococcal pneumonia, and 8.4% (5.3-12.5%), 9.4% (6.2-13.4), and 14.4% (10.4-20.0%) of pneumococcal sinusitis. Conclusions: We estimated high proportions of antibiotic-nonsusceptibility in nonbacteremic pneumococcal pneumonia and sinusitis in US adults. Use of PCVs and antibiotic stewardship may mitigate the burden of antibiotic-nonsusceptible pneumococcal disease.","journal":"Open Forum Infectious Diseases","year":2025,"id":537777,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8619,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":551952,"name":"Kristin L. Andrejko","orcid":"0000-0002-0808-0231","position":1,"is_corresponding":false},{"id":1424033,"name":"Miwako Kobayashi","orcid":"0000-0001-7544-0383","position":2,"is_corresponding":false},{"id":470962,"name":"Wei Xing","orcid":"0000-0003-2841-7206","position":3,"is_corresponding":false},{"id":771689,"name":"Adam L. Cohen","orcid":"0000-0002-8541-2287","position":4,"is_corresponding":false},{"id":668538,"name":"Joseph A Lewnard","orcid":null,"position":5,"is_corresponding":false},{"id":82830,"name":"Laura King","orcid":"0000-0002-7785-4712","position":0,"is_corresponding":true}],"reference_count":38,"raw_metadata":null,"created_at":"2026-07-19T02:52:16.891390Z","pmid":"41509677","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}