---
title: "Trends in Severe Pneumococcal Pneumonia in ICU Patients, 2010–2024"
id: "pubmed-42572802"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42572802"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42572802/"
doi: "10.4046/trd.2026.0003"
published_at: "2026-08-10T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Trends in Severe Pneumococcal Pneumonia in ICU Patients, 2010–2024
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42572802
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42572802/)
- **DOI:** [10.4046/trd.2026.0003](https://doi.org/10.4046%2Ftrd.2026.0003)
- **Published At:** 2026-08-10T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This single-center prospective ICU cohort analyzed adult patients with severe pneumonia admitted between 2010 and 2024 at a 2,700-bed tertiary hospital in South Korea. - Of 2,511 ICU admissions for severe pneumonia, **140 (5.6%)** were attributable to **pneumococcal** infections (Streptococcus pneumoniae). - The proportion of pneumococcal cases among severe pneumonia fell significantly across three 5-year periods: **9.9%** (2010–2014), **4.2%** (2015–2019), and **2.2%** (2020–2024) (p<0.001 for trend). - Despite declining case proportion, antimicrobial resistance to ceftriaxone increased markedly: ceftriaxone non-susceptibility rose from **4.8%** to **16.7%** and then **45.5%** across the same periods (p<0.001). - Respiratory co-infections were common and increased over time: co-infection rates were **48.9%**, **61.8%**, and **77.8%** in the three periods (p=0.02), driven largely by respiratory viruses. - Influenza was the leading co-pathogen in 2015–2019, while **SARS-CoV-2** predominated in 2020–2024. - Ninety-day mortality among pneumococcal ICU patients remained statistically similar across periods: **29.5%**, **38.2%**, and **27.8%** (p=0.64). - The authors caution interpretation because serotype data and individual vaccination status were not reported, and some antimicrobial susceptibility results were incomplete. - The study concludes that surveillance should continue for **pneumococcal disease**, evolving antimicrobial resistance, and changing patterns of respiratory co-infection in severe pneumonia requiring ICU care.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # Changing Epidemiology of Severe Pneumococcal Pneumonia in Adults at Tertiary Hospital between 2010-2024 [Sang-Ho Choi](https://pubmed.ncbi.nlm.nih.gov/?term=Choi+SH&cauthor_id=42572802)[#](https://pubmed.ncbi.nlm.nih.gov/42572802/#full-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#full-view-affiliation-1 "Department of Infectious diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Jin Won Huh](https://pubmed.ncbi.nlm.nih.gov/?term=Huh+JW&cauthor_id=42572802)[#](https://pubmed.ncbi.nlm.nih.gov/42572802/#full-view-equal-contrib-explanation "Contributed equally")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#full-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Sang-Bum Hong](https://pubmed.ncbi.nlm.nih.gov/?term=Hong+SB&cauthor_id=42572802)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#full-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Heungsup Sung](https://pubmed.ncbi.nlm.nih.gov/?term=Sung+H&cauthor_id=42572802)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#full-view-affiliation-3 "Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Kyung-Hyun Do](https://pubmed.ncbi.nlm.nih.gov/?term=Do+KH&cauthor_id=42572802)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#full-view-affiliation-4 "Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Sang-Oh Lee](https://pubmed.ncbi.nlm.nih.gov/?term=Lee+SO&cauthor_id=42572802)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#full-view-affiliation-1 "Department of Infectious diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Chae-Man Lim](https://pubmed.ncbi.nlm.nih.gov/?term=Lim+CM&cauthor_id=42572802)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#full-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Younsuck Koh](https://pubmed.ncbi.nlm.nih.gov/?term=Koh+Y&cauthor_id=42572802)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#full-view-affiliation-5 "Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. yskoh@amc.seoul.kr.") Affiliations Expand ### Affiliations * 1 Department of Infectious diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. * 2 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. * 3 Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. * 4 Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. * 5 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. yskoh@amc.seoul.kr. # Contributed equally. * PMID: **42572802** * DOI: [ 10.4046/trd.2026.0003 ](https://doi.org/10.4046/trd.2026.0003) Item in Clipboard # Changing Epidemiology of Severe Pneumococcal Pneumonia in Adults at Tertiary Hospital between 2010-2024 Sang-Ho Choi et al. Tuberc Respir Dis (Seoul). 2026. Show details Display options Display options Format Abstract PubMed PMID Tuberc Respir Dis (Seoul) Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Tuberc+Respir+Dis+%28Seoul%29%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Tuberc+Respir+Dis+%28Seoul%29%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42572802/) . 2026 Aug 10. doi: 10.4046/trd.2026.0003. Online ahead of print. ### Authors [Sang-Ho Choi](https://pubmed.ncbi.nlm.nih.gov/?term=Choi+SH&cauthor_id=42572802)[#](https://pubmed.ncbi.nlm.nih.gov/42572802/#short-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#short-view-affiliation-1 "Department of Infectious diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Jin Won Huh](https://pubmed.ncbi.nlm.nih.gov/?term=Huh+JW&cauthor_id=42572802)[#](https://pubmed.ncbi.nlm.nih.gov/42572802/#short-view-equal-contrib-explanation "Contributed equally")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#short-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Sang-Bum Hong](https://pubmed.ncbi.nlm.nih.gov/?term=Hong+SB&cauthor_id=42572802)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#short-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Heungsup Sung](https://pubmed.ncbi.nlm.nih.gov/?term=Sung+H&cauthor_id=42572802)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#short-view-affiliation-3 "Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Kyung-Hyun Do](https://pubmed.ncbi.nlm.nih.gov/?term=Do+KH&cauthor_id=42572802)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#short-view-affiliation-4 "Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Sang-Oh Lee](https://pubmed.ncbi.nlm.nih.gov/?term=Lee+SO&cauthor_id=42572802)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#short-view-affiliation-1 "Department of Infectious diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Chae-Man Lim](https://pubmed.ncbi.nlm.nih.gov/?term=Lim+CM&cauthor_id=42572802)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#short-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."), [Younsuck Koh](https://pubmed.ncbi.nlm.nih.gov/?term=Koh+Y&cauthor_id=42572802)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42572802/#short-view-affiliation-5 "Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. yskoh@amc.seoul.kr.") ### Affiliations * 1 Department of Infectious diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. * 2 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. * 3 Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. * 4 Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. * 5 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. yskoh@amc.seoul.kr. # Contributed equally. * PMID: **42572802** * DOI: [ 10.4046/trd.2026.0003 ](https://doi.org/10.4046/trd.2026.0003) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** The epidemiology of pneumococcal pneumonia can be influenced by vaccine implementation, serotype replacement, and viral circulation. We aimed to investigate 15-year trends in the epidemiological and clinical characteristics of severe pneumococcal pneumonia patients requiring intensive care unit (ICU) admission. **Methods:** We analyzed data from a prospective cohort of adult patients with severe pneumonia admitted to the 28-bed medical ICU of a 2,700-bed tertiary hospital in South Korea between 2010 and 2024. Temporal changes in incidence, resistance to antimicrobial agents, frequency of co-infections, and mortality were evaluated across three 5-year periods. **Results:** Among 2,511 ICU patients with severe pneumonia, 140 (5.6%) had pneumococcal infections. The proportion of pneumococcal cases decreased from 9.9% in 2010-2014 to 4.2% in 2015-2019, and further to 2.2% in 2020-2024 (p<0.001 for trend). Conversely, ceftriaxone non-susceptibility rates rose sharply from 4.8% to 16.7% and 45.5% across the same periods (p<0.001). Co-infections were frequent and increased significantly, largely due to respiratory viruses, with rates of 48.9%, 61.8%, and 77.8%, respectively (p=0.02). Influenza was the predominant co-pathogen during 2015-2019, whereas SARS-CoV-2 was most frequent in 2020-2024. The 90-day mortality rates remained stable over time (29.5%, 38.2%, and 27.8%, p=0.64). **Conclusions:** In this single-center ICU cohort, the proportion of severe pneumococcal pneumonia cases decreased over the 15-year period, whereas ceftriaxone non-susceptibility and viral co-infections became more frequent. These trends should be interpreted cautiously given the lack of serotype and individual vaccination data and incomplete susceptibility results. Continued surveillance of pneumococcal disease, antimicrobial resistance, and respiratory co-infections is warranted. **Keywords:** Antibiotic resistance; Coinfection; Severe pneumonia; Streptococcus pneumoniae. 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