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Table · dataset · 2026

Data Sheet 1_Hidden burden of pneumococcal colonization in adults with viral respiratory infections: the role of influenza and RSV.pdf

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Introduction<p>Although pneumococcal colonization is uncommon in adults, it may increase during respiratory viral infections.

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We investigated the frequency of pneumococcal colonization, associated factors, and serotype distribution in adults with confirmed respiratory viral infection.</p>Methods<p>We prospectively included adults presenting to the Emergency Department of Bellvitge University Hospital with influenza A virus (IAV), SARS-CoV-2, or respiratory syncytial virus (RSV) infection, as well as 33 virus-negative controls (December 2023–January 2024).

Nasopharyngeal swabs were tested for Streptococcus pneumoniae using a RT-PCR assay (lytA and piaB genes). Clinical data were analysed using Cox proportional hazards regression models.</p>Results<p>A total of 616 episodes were studied (IAV, n=391; SARS-CoV-2, n=162; RSV, n=28; >1 virus, n=35). Pneumococcal colonization was detected in 85 individuals, with the highest prevalence among IAV-infected patients (14.8%), followed by RSV (10.7%) and SARS-CoV-2 (9.3%).

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Individuals with viral infection showed higher pneumococcal loads (median lytA C<sub>T</sub> 23.1 [18.7–27.4]) compared to those without infection (C<sub>T</sub> 31.8 [31.5–33.3]). IAV (OR 3.52; 95%CI 1.30–9.17) and RSV (OR 4.04; 95%CI 1.11–13.50) were independently associated with pneumococcal colonization. Among adults <65 years, female sex (OR for male sex 0.43; 95% CI 0.19–0.90) was associated with colonization, whereas in those ≥65 years, RSV infection (OR 5.56; 95% CI 1.03–27.31) was the main association.

Detected serotypes were diverse, predominantly non-PCV serotypes.</p>Conclusions<p>Pneumococcal colonization was more frequent during IAV or RSV than SARS-CoV-2 infection. In older adults, RSV infection showed a particularly strong association, highlighting potential implications for pneumococcal and RSV vaccination strategies.</p>

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