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Inicio Medicina Clínica (English Edition) Pneumococcal pneumonia in adults 60 years or older: Incidence, mortality and pre...
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Vol. 146. Issue 5.
Pages 199-202 (March 2016)
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Vol. 146. Issue 5.
Pages 199-202 (March 2016)
Brief report
DOI: 10.1016/j.medcle.2015.09.001
Pneumococcal pneumonia in adults 60 years or older: Incidence, mortality and prevention
Neumonía neumocócica en adultos mayores de 60 años: incidencia, mortalidad y prevención
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Angel Vila-Corcolesa, Xabier Ansaa, Olga Ochoa-Gondara,
Corresponding author
oochoa.tarte.ics@gencat.cat

Corresponding author.
, Eva Satuea, Cinta de Diegoa, Teresa Rodriguez-Blancob, on behalf of EPIVAC Research Team
a Servicio de Atención Primaria Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
b Instituto Universitario de Investigación en Atención Primaria Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
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Tables (2)
Table 1. Incidence rates of hospitalization from pneumococcal pneumonia according to age strata, sex and type of residence.
Table 2. Prevalence of infections caused by serotypes included in the current antipneumococcal vaccines for adult population.
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Abstract
Background

This study investigated the burden (incidence, mortality and serotype distribution) of pneumococcal pneumonia among older adults in the region of Tarragona (Spain).

Methods

Population-based cohort study involving 27,204 individuals ≥60 years in Tarragonès county (Southern Catalonia), who were prospectively followed between 01/12/2008 and 30/11/2011. Bacteremic and nonbacteremic (positive sputum culture and/or urinary antigen test) pneumococcal pneumonias were recruited.

Results

A total of 125 pneumococcal pneumonias (16 bacteremic and 109 nonbacteremic) was observed. Incidence rates (per 1000 person-years) were 0.21 (95% confidence interval [CI]: 0.13–0.35) for bacteremic cases and 1.45 (95% CI: 1.20–1.75) for nonbacteremic cases. Case-fatality rate was 10.4% (12.5% in bacteremic and 10.1% in nonbacteremic cases). Five serotypes (types 3, 6C, 19A, 22F and 35B) were the most common serotypes, accounting for 64.3% of overall isolated serotypes. 73.1% of cases were due to the strains included in the 23-valent vaccine whereas 53.6% were due to the strains included in the 13-valent vaccine.

Conclusion

The burden of pneumococcal pneumonia remains considerable (especially among oldest people and nursing-home residents) despite a publicly funded anti-pneumococcal vaccination program operative for several years.

Keywords:
Epidemiology
Incidence
Mortality
Pneumococcal pneumonia
Streptococcus pneumoniae
Resumen
Fundamento

Este estudio analiza la epidemiología (incidencia, letalidad y distribución de serotipos) de la neumonía neumocócica en adultos mayores de Tarragona.

Métodos

Cohorte de base poblacional que incluyó 27.204 individuos60 años en la comarca del Tarragonès, con seguimiento prospectivo entre 1-12-2008 y 30-11-2011 y selección de todos los casos de neumonía neumocócica bacteriémica y no-bacteriémica (cultivo de esputo y/o antigenuria positiva).

Resultados

Se observaron 125 neumonías neumocócicas (16 bacteriémicas y 109 no bacteriémicas). Las tasas de incidencia (por 1.000 personas-año) fueron 0,21 (intervalo de confianza [IC] 95%: 0,13-0,35) para casos bacteriémicos y 1,45 (IC 95%: 1,20-1,75) para casos no bacteriémicos. La letalidad global fue del 10,4% (12,5% en casos bacteriémicos y 10,1% en no bacteriémicos). Cinco serotipos (3, 6C, 19A, 22F y 35B) fueron los más comunes, representando un 64,3% del total de serotipos aislados. Un 73,1% de los casos fueron debidos a serotipos incluidos en la vacuna 23-valente, mientras que un 53,6% fueron debidos a serotipos incluidos en la vacuna 13-valente.

Conclusión

La incidencia de neumonía neumocócica es considerable (especialmente en personas mayores y/o institucionalizadas) a pesar del programa público de vacunación antineumocócica implementado desde hace años.

Palabras clave:
Epidemiología
Incidencia
Letalidad
Neumonía neumocócica
Streptococcus pneumoniae

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