Trends in invasive and non-invasive Streptococcus pneumoniae disease in adults hospitalised in Bristol and Bath: a retrospective cohort study, 2006–2022

There is a substantial burden of pneumococcal disease that is not represented by studies that focus on invasive respiratory disease, or by surveillance that focus only on culture positive disease alone. Outcomes are particularly poor in the case of meningitis, but non-invasive disease also has a high case fatality rate. Given the same serotypes are found in meningitis as invasive respiratory disease, we anticipate that the same vaccines that target respiratory disease should be relevant to the prevention of meningitis.