Clinical and microbiological implications of invasive pneumococcal disease in hospitalized patients (1998–2013)

Abstract

The sample comprised 332 patients. Patient age ranged from less than one month to 89 years old (mean 20.3 years) and the sample was predominately male. Pneumonia (67.8%) was the most common disease, accounting for 18.2% of deaths. Serotypes 14, 1, 3, 9V, 6B, 6A, 23F, 19A, 18C, 19F, 12F, and 4 were the most common (75.3%). Most patients, or 67.5%, were cured without any complication (success), 6.9% had some type of sequela (failure), and 25.6% died (failure). In the case of deaths due to meningitis, strains of fully penicillin resistant pneumococcus were isolated. Furthermore, 68.2% of patients who died presented some type of comorbidity. The 60 and older age group presented the most significant association (Odds Ratio=4.2), with outcome failure regardless of the presence of comorbidity. Serotype 18C was the most significant risk factor both in raw analysis (Odds Ratio=3.8) and when adjusted for comorbidity (Odds Ratio=5.0) or age (Odds Ratio=5.4). The same occurred with serotype 12F (respectively, Odds Ratio=5.1, Odds Ratio=5.0, and Odds Ratio=4.7) CONCLUSION: The present findings highlight the importance of IPD among young adults and older adults. In the era of conjugate vaccines, monitoring serotypes in different age groups is essential to assess the impact and adequacy of immunization.

Impact after 10-year use of pneumococcal conjugate vaccine in the Brazilian national immunization program: an updated systematic literature review from 2015 to 2020

“…3 Among the vaccine target population, particularly < 5 year olds, vaccine-type IPD declined substantially post PHiD-CV introduction. 20,[26][27][28]36 Six studies reported that vaccination with PHiD-CV conferred a substantial reduction in vaccine-type IPD in the population not targeted by vaccination, in particular after 3 years of PHiD-CV use, leading to broader protection against vaccine-type IPD in all age groups. 17,20,27,28,42,45 It is known that pneumonia and AOM, when compared to IPD poses a higher overall public health burden and management costs from a societal perspective.…”

“…A total of 19 papers (out of 341 full-text journal publications identified from the online databases) [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] and 10 abstracts (out of 649 from relevant conference proceedings) [36][37][38][39][40][41][42][43][44][45] were included in the review (Figure 1). A summary of study characteristics is presented in Figure 2 and individual study details are provided in Table 2.…”

“…In terms of study designs, the most common was ecological database study (n = 13) 17,24,25,31-38,43,44 followed by surveillance-based (hospital-based or laboratory-based) (n = 9), [18][19][20]23,28,[40][41][42]45 cross-sectional (n = 5), 21,22,27,29,39 cohort (n = 1), 30 and case series (n = 1) ( Figure 2B).…”

“…39,40,45 Nine studies reported data in individuals of all ages ( Figure 2C). [18][19][20]23,[26][27][28]41,42 Most studies reported IPD as the outcome (n = 10), 19,20,23,[26][27][28]36,40,42,45 followed by pneumonia (n = 9), 17,24,25,32,35,37,38,43,44 community-acquired pneumonia (CAP) (n = 3), 33,34,39 pneumococcal meningitis (n = 3), 18,21,41 AOM/Otitis Media (OM) (n = 2) 30,31 and nasopharyngeal carriage (n = 3). 21,22,29 An overview of studies by outcome and target age group is provided in Figure 2D and Supplementary Figure 2.…”

“…Evidence on the overall impact of PHiD-CV on IPD and pneumococcal meningitis was reported in ten studies, 19,20,23,[26][27][28]36,40,42,45 and three studies, 18,20,41 respectively (Table 2). Overall, a decrease in the direct and indirect burden of IPD and pneumococcal meningitis after PHiD-CV introduction was documented in children < 5 years of age, with a higher number of cases of pneumococcal meningitis reported in adults.…”