Redefining risk categories for pneumococcal disease in adults: critical analysis of the evidence

Curcio, Daniel; Cané, Alejandro; Istúriz, Raúl

doi:10.1016/j.ijid.2015.05.003

Cited by 49 publications

(32 citation statements)

References 45 publications

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“…Moore et al found that 76% of the adults with IPD in the USA had an indication for pneumococcal vaccination [16]. While comorbidities that are risk factors for IPD are well recognized and are for the most part indications for vaccination what is not readily recognized is the concept of risk factor stacking [29]. For example, when smoking is added to diabetes, chronic obstructive lung disease, and chronic heart disease the odds ratio for acquisition of IPD increases from 8.5 to >40 [29].…”

Section: Discussionmentioning

confidence: 99%

“…While comorbidities that are risk factors for IPD are well recognized and are for the most part indications for vaccination what is not readily recognized is the concept of risk factor stacking [29]. For example, when smoking is added to diabetes, chronic obstructive lung disease, and chronic heart disease the odds ratio for acquisition of IPD increases from 8.5 to >40 [29]. The highest rates of IPD are seen among those who are immunocompromised either by underlying disease or by treatment.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Invasive Pneumococcal Disease: Still Lots to Learn and a Need for Standardized Data Collection Instruments

Marrie

Tyrrell

Majumdar

et al. 2017

Canadian Respiratory Journal

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Background. Large studies of invasive pneumococcal disease (IPD) are frequently lacking detailed clinical information. Methods. A population-based 15-year study of IPD in Northern Alberta. Results. 2435 patients with a mean age of 54.2 years formed the study group. Males outnumbered females and Aboriginal and homeless persons were overrepresented. High rates of smoking, excessive alcohol use, and illicit drug use were seen. Almost all (87%) had a major comorbidity and 15% had functional limitations prior to admission. Bacteremia, pneumonia, and meningitis were the most common major manifestations of IPD. Almost half of the patients had alteration of mental status at the time of admission and 22% required mechanical ventilation. Myocardial infarction, pulmonary embolism, and new onset stroke occurred in 1.7, 1.3, and 1.1% of the patients, respectively; of those who had echocardiograms, 35% had impaired ventricular function. The overall in-hospital mortality was 15.6%. Conclusions. IPD remains a serious infection in adults. In addition to immunization, preventative measures need to consider the sociodemographic features more carefully. A standard set of data need to be collected so that comparisons can be made from study to study. Future investigations should target cardiac function and pulmonary embolism prevention in this population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Invasive Pneumococcal Disease: Still Lots to Learn and a Need for Standardized Data Collection Instruments

Marrie

Tyrrell

Majumdar

et al. 2017

Canadian Respiratory Journal

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show abstract

“…Bir arada bulunan ≥2 komorbiditesi olan eriş-kinlerdeki pnömokok hastalığı insidans hızlarının, yüksek risk altında olduğu kabul edilenlerdeki kadar ya da onlardan bile yüksek olduğu gözlenmiştir (26). Benzer biçimde, yayımlan-mış 38 çalışmanın sonuçlarının analizi de "risk altında" olarak kabul edilen ancak diabetes mellitus, kronik kalp hastalığı ve kronik obstrüktif akciğer hastalığı gibi komorbiditelerinin sayısı ≥2 olan hastaları, "yüksek risk" kategorisinde sınıflan-dırmak gerekebileceğini göstermiştir (27). ABD'de 2002-2011 arasında gazilerin başvurduğu tıp merkezlerinde ciddi pnö-mokok infeksiyonu saptanan ≥50 yaşındaki aşısız erişkinler-de, örneğin ≥65 yaşında olma, alkolizm, kronik kalp hastalığı, kronik karaciğer hastalığı, kronik solunum hastalığı, diabetes mellitus, immün yetmezlik ya da tütün kullanımı gibi çok sayı-daki yığılmış risk faktöründen ("stacked risk") altısını birden taşıyanlardaki 30 günlük mortalite, tek bir risk faktörünü taşı-yanlara göre yaklaşık üç kat daha yüksek bulunmuştur (28).…”

Section: Tanımlarunclassified

Pneumococcal Vaccine as One of the Immunization Coverage Targets For Adulthood Vaccines: A Consensus Report of the Study Group For Adult Immunization of the Turkish Society of Clinical Microbiology and Infectious Diseases

Şenol¹,

Azap²,

Erbay³

et al. 2018

Klimik Dergisi

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Pneumococcal diseases, including pneumonia with or without bacteremia, remain an important cause of morbidity and mortality in adults, especially among the elderly and those with certain medical conditions, including immunocompromising conditions all over the world. Two pneumococcal vaccines are currently licensed for adults in Turkey, 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23). PPSV23 has been available for many years for use in adults. A 7-valent pneumococcal conjugate vaccine (PCV7) included in the Expanded Programme on Immunization for use in infants and children in 2008, and thereafter PCV13 replaced PCV7 in 2011. Recently, the Ministry of Health of Turkey accepted risk groups for vaccine-preventable diseases, and implemented their immunization schedules in accordance with the decisions of Immunization Advisory Committee, including adult pneumococcal vaccination greatly compatible with those of updated U.S. Advisory Committee on Immunization Practices (ACIP) recommendations such as PCV13 for selected high-risk adults and for all adults ≥65 years of age. Furthermore, surveillance of invasive pneumococcal disease has already been included as part of the Surveillance of Vaccine-Preventable Invasive Bacterial Diseases announced that would be started soon in Turkey. In this consensus report prepared by Study Group for Adult Immunization of the Turkish Society of Clinical Microbiology and Infectious Diseases, relevant literature ÖzetPnömokok hastalıkları, bakteriyemik olan ya da olmayan pnömoni başta olmak üzere, özellikle yaşlılarda ve immün sistemi zayıfla-tan durumlar gibi birtakım sağlık sorunları olan erişkinlerde, tüm dünyada önemli bir morbidite ve mortalite nedeni olmaya devam etmektedir. Ülkemizde 13 valan konjuge pnömokok aşısı (KPA13) ve 23 valan polisakarid pnömokok aşısı (PPA23) olmak üzere eriş-kinler için ruhsatlandırılmış iki aşı vardır. PPA23 erişkinlerde yıl-lardır kullanılmaktadır. 2008'de 7 valan konjuge pnömokok aşısı (KPA7) çocuklarda kullanılmak üzere Genişletilmiş Bağışıklama Programı'na alınmıştır; daha sonra 2011'de KPA7 yerini KPA13'e bırakmıştır. Yakınlarda Sağlık Bakanlığı'nca, Bağışıklama Danışma Kurulu kararları doğrultusunda, aşıyla önlenebilir hastalıklar açı-sından risk grupları kabul edilmiş ve bunlara uygulanması gereken, aralarında erişkinlerde pnömokok aşılamasının da bulunduğu aşı şemaları yürürlüğe konulmuştur. Bu şemalar, pnömokok aşıları yö-nünden, KPA13'ün hem yüksek risk altındaki erişkinlere hem de ≥65 yaşındaki tüm erişkinlere uygulanması gibi ABD'deki güncel Advisory Committee on Immunization Practices (ACIP) önerileriy-le büyük ölçüde örtüşmektedir. Ayrıca, yakınlarda yayımlanan bir genelgeyle ülkemizde de başlatılacağı açıklanan invazif pnömokok hastalıkları sürveyansı, Aşıyla Önlenebilir İnvazif Bakteriyel Hastalıkların Sürveyansı programının kapsamına alınmıştır. Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği Erişkin Bağışıkla-ması Çalışma Grubu'nca hazırlanan bu uzlaşı raporun...

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“…Indeed, in 2014, a total of 952 IPD cases were notified (accounting for 78% of all cases), while cases of invasive diseases caused by Neisseria meningitidis accounted for 163 (13%) and those caused by Haemophilus influenzae accounted for 105 (9%) [4]. The risk of developing IPD is unevenly distributed among different population groups, being significantly higher among young children, the elderly, and people with several underlying medical conditions and health-compromising behaviors [5,6]. …”

Section: Introductionmentioning

confidence: 99%

An eHealth Project on Invasive Pneumococcal Disease: Comprehensive Evaluation of a Promotional Campaign

Panatto¹,

Domnich²,

Gasparini³

et al. 2016

J Med Internet Res

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BackgroundThe recently launched Pneumo Rischio eHealth project, which consists of an app, a website, and social networking activity, is aimed at increasing public awareness of invasive pneumococcal disease (IPD). The launch of this project was prompted by the inadequate awareness of IPD among both laypeople and health care workers, the heavy socioeconomic burden of IPD, and the far from optimal vaccination coverage in Italy, despite the availability of safe and effective vaccines.ObjectiveThe objectives of our study were to analyze trends in Pneumo Rischio usage before and after a promotional campaign, to characterize its end users, and to assess its user-rated quality.MethodsAt 7 months after launching Pneumo Rischio, we established a 4-month marketing campaign to promote the project. This intervention used various approaches and channels, including both traditional and digital marketing strategies. To highlight usage trends, we used different techniques of time series analysis and modeling, including a modified Mann-Kendall test, change-point detection, and segmented negative binomial regression of interrupted time series. Users were characterized in terms of demographics and IPD risk categories. Customer-rated quality was evaluated by means of a standardized tool in a sample of app users.ResultsOver 1 year, the app was accessed by 9295 users and the website was accessed by 143,993 users, while the project’s Facebook page had 1216 fans. The promotional intervention was highly effective in increasing the daily number of users. In particular, the Mann-Kendall trend test revealed a significant (P ≤.01) increasing trend in both app and website users, while change-point detection analysis showed that the first significant change corresponded to the start of the promotional campaign. Regression analysis showed a significant immediate effect of the intervention, with a mean increase in daily numbers of users of 1562% (95% CI 456%-4870%) for the app and 620% (95% CI 176%-1777%) for the website. Similarly, the postintervention daily trend in the number of users was positive, with a relative increase of 0.9% (95% CI 0.0%-1.8%) for the app and 1.4% (95% CI 0.7%-2.1%) for the website. Demographics differed between app and website users and Facebook fans. A total of 69.15% (10,793/15,608) of users could be defined as being at risk of IPD, while 4729 users expressed intentions to ask their doctor for further information on IPD. The mean app quality score assigned by end users was approximately 79.5% (397/500).ConclusionsDespite its specific topic, Pneumo Rischio was accessed by a considerable number of users, who ranked it as a high-quality project. In order to reach their target populations, however, such projects should be promoted.

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Redefining risk categories for pneumococcal disease in adults: critical analysis of the evidence

Cited by 49 publications

References 45 publications

Invasive Pneumococcal Disease: Still Lots to Learn and a Need for Standardized Data Collection Instruments

Invasive Pneumococcal Disease: Still Lots to Learn and a Need for Standardized Data Collection Instruments

Pneumococcal Vaccine as One of the Immunization Coverage Targets For Adulthood Vaccines: A Consensus Report of the Study Group For Adult Immunization of the Turkish Society of Clinical Microbiology and Infectious Diseases

An eHealth Project on Invasive Pneumococcal Disease: Comprehensive Evaluation of a Promotional Campaign

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