Epidemiology of invasive pneumococcal infections: manifestations, incidence and case fatality rate correlated to age, gender and risk factors

Abstract

BackgroundIncidence, manifestations and case-fatality rate (CFR) of invasive pneumococcal disease (IPD) vary with age and comorbidities. New vaccines, changing age distribution, prolonged survival among immunocompromised patients and improved sepsis management have created a need for an update of basic facts to inform vaccine recommendations.MethodsAge, gender and comorbidities were related to manifestations and death for 2977 consecutive patients with IPD in a Swedish region with 1.5 million inhabitants during 13 years before introduction of pneumococcal conjugate vaccines (PCV) in the infant vaccination program. These data were related to population statistics and prevalence of several comorbidities, and compared with two previous studies giving a total follow-up of 45 years in the same area.ResultsThe annual incidence was 15/100,000 for any IPD and 1.1/100,000 for meningitis; highest among elderly followed by children < 2 years. It was 2238/100,000 among myeloma patients, followed by chronic lymphatic leukemia, hemodialysis and lung cancer, but not elevated among asthma patients. CFR was 10 % among all patients, varying from 3 % below 18 years to 22 % ≥ 80 years. During 45 years, the IPD incidence increased threefold and CFR dropped from 20 to 10 %. Meningitis incidence remained stable (1.1/100,000/year) but CFR dropped from 33 to 13 %. IPD-specific mortality decreased among children <2 years from 3.1 to 0.46/100,000/year but tripled among those ≥65 years.ConclusionsIPD incidence and CFR vary widely between age and risk groups and over time even without general infant vaccination. Knowledge about specific epidemiological characteristics is important for informing and evaluating vaccination policies.

Update of the recommendations of the Italian Society of Medical Oncology on vaccination for seasonal influenza and pneumococcal infection in patients with cancer: Focus on prevention of pneumonia

“…The risk to die within 30 days for patients with pneumonia and any comorbidity has been reported 3.4 times higher than for patients without comorbidities, the highest relative death risk among patients with solid tumours (especially lung cancer) (Backhaus et al, 2016). The risk to die within 30 days for patients with pneumonia and any comorbidity has been reported 3.4 times higher than for patients without comorbidities, the highest relative death risk among patients with solid tumours (especially lung cancer) (Backhaus et al, 2016).…”

Risk factors for infections in newly diagnosed Multiple Myeloma patients: A Danish retrospective nationwide cohort study

“…3 The authors found high risk of both bacterial and viral diseases during the first year from MM diagnosis. 3 Backhaus et al 4 recently showed that the incidence of invasive pneumococcal disease is 154 times higher in MM patients compared to persons without MM. Augustson et al found that infections are the most common cause of death within the first 2 months from diagnosis based on data from before the introduction of novel anti-myeloma treatment and we have recently shown in a population-based study that infections are a major cause of early death in MM patients.…”

Measuring quantity and function of pneumococcal antibodies in immunoglobulin products

“…Pneumococcal infections are more common and also tend to be more severe in certain populations. Young children, elderly adults, and individuals with immunodeficiency and chronic medical conditions have increased susceptibility to, and increased morbidity from, pneumococcal infections …”

“…Young children, elderly adults, and individuals with immunodeficiency and chronic medical conditions have increased susceptibility to, and increased morbidity from, pneumococcal infections. 7,8 In the late 19th and early 20th centuries before the advent of antibiotics, patients with pneumococcal infections were treated with immune serum. 9,10 Experience with serum treatments taught investigators the mechanisms of immune protection against pneumococcal infections.…”