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

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
T. J. Marrie ◽  
G. J. Tyrrell ◽  
Sumit R. Majumdar ◽  
Dean T. Eurich
Keyword(s):  
Pulmonary Embolism ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Functional Limitations ◽  
Clinical Information ◽  
Population Based ◽  
Homeless Persons ◽  
Preventative Measures ◽  
Almost All ◽  
Time Of Admission

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.

scholarly journals Homelessness in Adults With Invasive Pneumococcal Disease in Calgary, Canada

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Julie-Anne Lemay ◽  
Leah J Ricketson ◽  
Lauren Zwicker ◽  
James D Kellner
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Drug Users ◽  
Population Based ◽  
Homeless Persons ◽  
Primary Diagnosis ◽  
Alcohol Abusers ◽  
Lower Odds ◽  
Relationship Of ◽  
The Relationship

Abstract Background Homelessness is uncommon but is frequently a characteristic in adults with invasive pneumococcal disease (IPD). In Calgary, homeless persons comprise approximately 0.2% of the population. We evaluated the relationship of homelessness and IPD in Calgary. Methods Demographic, clinical, and microbiologic data were collected by the Calgary Streptococcus pneumoniae Epidemiology Research (CASPER) team through prospective, population-based surveillance of all IPD cases. Here, we report on cases in adults (≥18 years) from 2000 to 2016. Results Of 1729 IPD cases, 321 (18.8%) occurred in homeless persons. Compared with nonhomeless persons, homeless persons were younger, more often male, smokers, alcohol abusers, illegal drug users, and had a primary diagnosis of pneumonia. In multivariable models of outcomes, homeless persons had lower odds of being admitted to the ICU (odds ratio [OR], 0.7; P = .02) and lower odds of death (OR, 0.6; P = .146). IPD caused by serotypes 4, 5, or 8, which have caused outbreaks in Calgary, was more common in homeless persons (54.4% vs 21.0%; P < .001). In addition, regardless of homeless status, persons with IPD caused by serotypes 4, 5, or 8 had lower odds of ICU admission and mortality (OR, 0.7; P = .017; and OR, 0.4; P = .004; respectively). Conclusions Homelessness is overrepresented in IPD cases in Calgary, despite most homeless persons having fewer risk factors than the overall population of persons with IPD. Most cases are caused by serotypes in both the 23-valent polysaccharide vaccine and the 13-valent conjugate vaccine. Thus, enhanced efforts are needed to deliver both vaccines to this vulnerable population.

scholarly journals Coeliac disease and invasive pneumococcal disease: a population-based cohort study

2017 ◽  
Vol 145 (6) ◽  
pp. 1203-1209 ◽  
Author(s):  
A. RÖCKERT TJERNBERG ◽  
J. BONNEDAHL ◽  
M. INGHAMMAR ◽  
A. EGESTEN ◽  
G. KAHLMETER ◽  
...  
Keyword(s):  
Cohort Study ◽  
Coeliac Disease ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Cox Regression ◽  
Statistical Significance ◽  
Pneumococcal Vaccination ◽  
Population Based ◽  
Increased Risk ◽  
Severe Infections

SUMMARYSevere infections are recognized complications of coeliac disease (CD). In the present study we aimed to examine whether individuals with CD are at increased risk of invasive pneumococcal disease (IPD). To do so, we performed a population-based cohort study including 29 012 individuals with biopsy-proven CD identified through biopsy reports from all pathology departments in Sweden. Each individual with CD was matched with up to five controls (n = 144 257). IPD events were identified through regional and national microbiological databases, including the National Surveillance System for Infectious Diseases. We used Cox regression analyses to estimate hazard ratios (HRs) for diagnosed IPD. A total of 207 individuals had a record of IPD whereas 45/29 012 had CD (0·15%) and 162/144 257 were controls (0·11%). This corresponded to a 46% increased risk for IPD [HR 1·46, 95% confidence interval (CI) 1·05–2·03]. The risk estimate was similar after adjustment for socioeconomic status, educational level and comorbidities, but then failed to attain statistical significance (adjusted HR 1·40, 95% CI 0·99–1·97). Nonetheless, our study shows a trend towards an increased risk for IPD in CD patients. The findings support results seen in earlier research and taking that into consideration individuals with CD may be considered for pneumococcal vaccination.

Increased long-term mortality after survival of invasive pneumococcal disease: a population-based study

2017 ◽  
Vol 49 (5) ◽  
pp. 365-372 ◽  
Author(s):  
Hans Kristian Floeystad ◽  
Are Holm ◽  
Leiv Sandvik ◽  
Didrik Frimann Vestrheim ◽  
Bjorn Brandsaeter ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Population Based ◽  
Population Based Study ◽  
Long Term Mortality

scholarly journals Effects of PCV7 and PCV13 on invasive pneumococcal disease and carriage in Stockholm, Sweden

2016 ◽  
Vol 47 (4) ◽  
pp. 1208-1218 ◽  
Author(s):  
Ilias Galanis ◽  
Ann Lindstrand ◽  
Jessica Darenberg ◽  
Sarah Browall ◽  
Priyanka Nannapaneni ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Clinical Information ◽  
Immunisation Programme ◽  
The Elderly ◽  
Older Children ◽  
Serotype Distribution ◽  
Vaccine Introduction ◽  
Herd Protection

The effects of pneumococcal conjugated vaccines (PCVs) need to be investigated. In Stockholm County, Sweden, PCV7 was introduced in the childhood immunisation programme in 2007 and changed to PCV13 in 2010.Over 90% of all invasive isolates during 2005–2014 (n=2336) and carriage isolates, 260 before and 647 after vaccine introduction, were characterised by serotyping, molecular typing and antibiotic susceptibility, and serotype diversity was calculated. Clinical information was collected for children and adults with invasive pneumococcal disease (IPD).The IPD incidence decreased post-PCV7, but not post-PCV13, in vaccinated children. Beneficial herd effects were seen in older children and adults, but not in the elderly. The herd protection was more pronounced post-PCV7 than post-PCV13. PCV7 serotypes decreased. IPD caused by PCV13 serotypes 3 and 19A increased post-PCV7. Post-PCV13, serotypes 6A and 19A, but not serotype 3, decreased. The serotype distribution changed in carriage and IPD to nonvaccine types, also in nonvaccinated populations. Expansion of non-PCV13 serotypes was largest following PCV13 introduction. Serotype diversity increased and nonvaccine clones emerged, such as CC433 (serotype 22F) in IPD and CC62 (serotype 11A) in carriage. In young children, meningitis, septicaemia and severe rhinosinusitis, but not bacteraemic pneumonia, decreased.Pneumococcal vaccination leads to expansion of new or minor serotypes/clones, also in nonvaccinated populations.

scholarly journals Population-based estimates of the effectiveness of pneumococcal vaccination in Australia

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Heather Gidding ◽  
Hannah Moore ◽  
Lisa McCallum ◽  
Parveen Fathima ◽  
Thomas Snelling ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Vaccine ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Population Based ◽  
Vaccine Effectiveness ◽  
Hazard Ratio ◽  
Cox Proportional Hazards Model ◽  
Universal Program ◽  
National Immunisation

ABSTRACTObjectivesAustralia’s Childhood Immunisation Register (ACIR) is one of only a handful of national immunisation registers world-wide. We have, for the first time, linked the ACIR to other health datasets to measure the real-world impact of Australia’s immunisation program. In this study, we aimed to assess the population-based effectiveness of the 3-dose infant pneumococcal vaccination program (due at 2, 4, and 6 months) against invasive pneumococcal disease caused by the 7 vaccine specific serotypes. The 7-valent pneumococcal conjugate vaccine (PCV7) has been available since 2001 and a funded universal program started in 2005 (with a switch to 13-valent PCV in 2011). ApproachVaccination records from ACIR, death records, and invasive pneumococcal disease notifications for 2001-2013 were individually linked for 1.37 million children born in 2001-2012 in two Australian states (Western Australia and New South Wales). A Cox proportional hazards model (adjusting for sex, Indigenous status and year of birth) was used to estimate the hazard ratio for invasive pneumococcal disease in vaccinated compared to unvaccinated children less than 2 years old. The per cent of disease prevented by vaccination, or vaccine effectiveness, was calculated as (1-adjusted hazard ratio) x 100%. ResultsFrom 2005, vaccination coverage with dose 3 of the pneumococcal vaccine was steady at ~91% in eligible cohorts. Between 2001 and 2013, there were 468 notifications of invasive pneumococcal disease caused by the 7 vaccine specific serotypes during 2.66 million person years of observation; only 39 (8.3%) of these cases occurred after the universal program was implemented. Vaccine effectiveness against invasive pneumococcal disease caused by the 7 vaccine specific serotypes for 1, 2 and 3 doses of the pneumococcal vaccine was 68% (95%CI: 44-89%), 93% (81-97%), and 92% (95%CI: 86-93%), respectively. ConclusionThis is the first study to link Australia’s national immunisation register and measure population-based vaccine effectiveness. The study provides robust evidence of the effectiveness of at least 2 doses of pneumococcal vaccine against vaccine serotype specific infection using a 3 dose infant schedule.

scholarly journals The Risk of Invasive Pneumococcal Disease Differs between Risk Groups in Norway Following Widespread Use of the 13-Valent Pneumococcal Vaccine in Children

2021 ◽  
Vol 9 (8) ◽  
pp. 1774
Author(s):  
Brita Askeland Winje ◽  
Didrik Frimann Vestrheim ◽  
Richard Aubrey White ◽  
Anneke Steens
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Risk Group ◽  
Population Data ◽  
Risk Groups ◽  
The Elderly ◽  
Population Based ◽  
Childhood Vaccination ◽  
Medical Risk ◽  
Icd 10

The elderly and adults with medical risk conditions remain at high risk of invasive pneumococcal disease (IPD), highlighting the importance of adequate preventive efforts. In an observational population-based study in Norway (pop ≥ 5 years, 2009–2017) covering six years post-PCV13 implementation, we explored the incidence and risk of IPD associated with age and comorbidities. We obtained the data on 5535 IPD cases from the Norwegian Surveillance System for Communicable Diseases and the population data from Statistics Norway. To define comorbidities, we obtained ICD-10 codes from the Norwegian Patient Registry for the cases and the Norwegian population. The average annual decrease in PCV13 IPD incidence was significant in all risk groups and decreased post-PCV13 introduction by 16–20% per risk group, implying a nondifferential indirect protection from the childhood vaccination. The IPD incidence remained high in the medical risk groups. The relative importance of medical risk conditions was 2.8 to 6 times higher in those aged 5–64 versus ≥65 years for all types of IPD, since age itself is a risk factor for IPD. In groups without medical risk, the risk of IPD was eight times higher in those aged ≥65 compared to those 5–64 years (RR 8.3 (95% CI 7.3–9.5)). Our results underscore the need for age- and risk-group-based prevention strategies.

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