Evolution of pneumococcal serotypes, vaccination uptake, and prognosis of invasive pneumococcal disease: A 9-year multicentre cohort study in Granada (Andalusia, Spain) Marín-Caba, Elvira Reinoso Camino, Mario Enrique Chueca Porcuna, Natalia Cobo, Fernando Valero Ubierna, Carmen Enríquez Maroto, María Francisca Rivera Izquierdo, Mario Jiménez Moleón, José Juan Streptococcus pneumoniae Pneumococcal disease Pneumococcal vaccine Objective: Our aim was to analyse the serotypes, vaccination and risk factors associated with in-hospital mortality in patients diagnosed with invasive pneumococcal disease (IPD) in two hospitals in Spain. Methods: A retrospective cohort study (2015–2024). Inclusion criteria were adults with IPD and with a serotyped sample registered in our microbiology services. Data were obtained through electronic medical records. The main exposure was pneumococcal vaccination, and the main outcome was in-hospital mortality. Bivariate, multivariable, and survival analyses were performed using R. Results: A total of 188 patients with IPD were included. The most frequent serotypes were 8, 3, 22F, 9 N and 11A. No previous pneumococcal vaccination was shown in 106 (58.6 %) patients. More than 30 % of serotypes were not included in the pneumococcal vaccines currently used in Spain. In-hospital mortality occurred in 27 (14.4 %) patients. Cox regression models showed older age (HR = 1.05, 95 %CI: 1.02–1.08), living in long-term care facilities (HR: 3.27, 95 %CI: 1.36–7.82), septic shock at admission (HR = 2.71; 95 %CI: 1.30–5.67), intensive care admission (HR = 2.64; 95 %CI: 1.53–4.57) and no previous pneumococcal vaccination (HR = 2.14; 95 %CI: 1.86–2.47) as the main factors associated with higher in-hospital mortality due to IPD. Conclusions: Low frequency of pneumococcal vaccination uptake in adult patients with IPD was demonstrated. Older age, living in long-term care facilities, dependency, septic shock at admission, and no previous pneumococcal vaccination were associated with higher in-hospital mortality. Immunization strategies should imperatively be optimised so as to reduce mortality from IPD. 2026-01-23T10:47:27Z 2026-01-23T10:47:27Z 2026-02 journal article Elvira Marín-Caba, Mario Enrique Reinoso-Camino, Natalia Chueca-Porcuna, Fernando Cobo, Carmen Valero-Ubierna, María Francisca Enríquez-Maroto, Mario Rivera-Izquierdo, José Juan Jiménez-Moleón, Evolution of pneumococcal serotypes, vaccination uptake, and prognosis of invasive pneumococcal disease: A 9-year multicentre cohort study in Granada (Andalusia, Spain), Infectious Diseases Now, Volume 56, Issue 2, 2026, 105244, ISSN 2666-9919, https://doi.org/10.1016/j.idnow.2026.105244 https://hdl.handle.net/10481/110138 10.1016/j.idnow.2026.105244 eng http://creativecommons.org/licenses/by/4.0/ open access Atribución 4.0 Internacional Elsevier