The Burden of Community‐Acquired Pneumonia in Seniors: Results of a Population‐Based Study

Jackson, Michael L.; Neuzil, Kathleen M.; Thompson, W.; Shay, David K.; Yu, Onchee; Hanson, Christi A.; Jackson, Lisa A.

doi:10.1086/425615

Cited by 395 publications

(394 citation statements)

References 19 publications

(20 reference statements)

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“…Many workingage adults with influenza do not present for medical attention although they may still incur absenteeism and productivity losses [1,39]. Previous studies have suggested that patients with diabetes who experience infectious diseases may be more likely to present for medical attention and to be hospitalised [40,41], and this may lead to overestimates of influenza-attributable illness specifically in diabetic adults. Because increased medical attention likely applies generally, regardless of infectious aetiology (e.g.…”

Section: Discussionmentioning

confidence: 99%

Working-age adults with diabetes experience greater susceptibility to seasonal influenza: a population-based cohort study

et al. 2014

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Aims/hypothesis The aim of this work was to compare the incidence of illness attributable to influenza in working-age adults (age <65 years) with and without diabetes. Methods We performed a cohort study using administrative data from Manitoba, Canada, between 2000 and 2008. All working-age adults with diabetes were identified and matched with up to two non-diabetic controls. We analysed the rates of influenza-like illness physician visits and hospitalisations, pneumonia and influenza hospitalisations, and all-cause hospitalisations. Multivariable regressions were used to estimate the influenza-attributable rate of each outcome. Results We included 745,777 person-years of follow-up among 166,715 subjects. The median age was 50-51 years and 48-49% were women; adults with diabetes had more comorbidities and were more likely to be vaccinated for influenza than those without diabetes. Compared with similar adults without diabetes, those with diabetes had a 6% greater (RR 1.06, 95% CI 1.02, 1.10; absolute risk difference 6 per 1,000 adults per year) increase in all-cause hospitalisations associated with influenza, representing a total of 54 additional hospitalisations. There were no differences in the influenzaattributable rates of influenza-like illness (p = 0.06) or pneumonia and influenza (p = 0.11). Conclusions/interpretation Guidelines calling for influenza vaccinations in diabetic, in addition to elderly, adults implicitly single out working-age adults with diabetes. The evidence supporting such guidelines has hitherto been scant. We found that working-age adults with diabetes appear more susceptible to serious influenza-attributable illness. These findings represent the strongest available evidence for targeting diabetes as an indication for influenza vaccination, irrespective of age.

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Section: Discussionmentioning

confidence: 99%

Working-age adults with diabetes experience greater susceptibility to seasonal influenza: a population-based cohort study

et al. 2014

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“…From the cost study performed in Sao Paulo State, Jackson et al 5 in 2004, 12.5% of the patients over 80 years-old admitted to hospital for pneumonia die while in the hospital.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of pneumococcal polysaccharide vaccination from age 60 in São Paulo State, Brazil

et al. 2011

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“…4 In USA, pneumonia rates for individuals between 65 and 69 years old were ª 2015 John Wiley & Sons Ltd, Immunology, 146, 100-112 18Á2/1000 person-years and 52Á3/1000 person-years for individuals over 85 years of age. 5 S. pneumoniae contains several virulence factors used to evade the immune response at different stages of infection. [6][7][8] For instance, this bacterium is able to prevent phagocytosis and complement binding, induce necrosis of immune cells and cleavage of IgA antibodies.…”

Section: Introductionmentioning

confidence: 99%

Interleukin‐10 plays a key role in the modulation of neutrophils recruitment and lung inflammation during infection by Streptococcus pneumoniae

et al. 2015

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Summary Streptococcus pneumoniae is a major aetiological agent of pneumonia worldwide, as well as otitis media, sinusitis, meningitis and sepsis. Recent reports have suggested that inflammation of lungs due to S. pneumoniae infection promotes bacterial dissemination and severe disease. However, the contribution of anti‐inflammatory molecules to the pathogenesis of S. pneumoniae remains unknown. To elucidate whether the production of the anti‐inflammatory cytokine interleukin‐10 (IL‐10) is beneficial or detrimental for the host during pneumococcal pneumonia, we performed S. pneumoniae infections in mice lacking IL‐10 (IL‐10−/− mice). The IL‐10−/− mice showed increased mortality, higher expression of pro‐inflammatory cytokines, and an exacerbated recruitment of neutrophils into the lungs after S. pneumoniae infection. However, IL‐10−/− mice showed significantly lower bacterial loads in lungs, spleen, brain and blood, when compared with mice that produced this cytokine. Our results support the notion that production of IL‐10 during S. pneumoniae infection modulates the expression of pro‐inflammatory cytokines and the infiltration of neutrophils into the lungs. This feature of IL‐10 is important to avoid excessive inflammation of tissues and to improve host survival, even though bacterial dissemination is less efficient in the absence of this cytokine.

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The Burden of Community‐Acquired Pneumonia in Seniors: Results of a Population‐Based Study

Abstract: On the basis of these data, we estimate that roughly 915,900 cases of community-acquired pneumonia occur annually among seniors in the United States and that approximately 1 of every 20 persons aged >or=85 years will have a new episode of community-acquired pneumonia each year.

Cited by 395 publications

References 19 publications

Working-age adults with diabetes experience greater susceptibility to seasonal influenza: a population-based cohort study

Working-age adults with diabetes experience greater susceptibility to seasonal influenza: a population-based cohort study

Cost-effectiveness analysis of pneumococcal polysaccharide vaccination from age 60 in São Paulo State, Brazil

Interleukin‐10 plays a key role in the modulation of neutrophils recruitment and lung inflammation during infection by Streptococcus pneumoniae

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