Incidence and Estimated Vaccine Effectiveness Against Hospitalizations for All-Cause Pneumonia Among Older US Adults Who Were Vaccinated and Not Vaccinated With 13-Valent Pneumococcal Conjugate Vaccine

Hsiao, Amber; Hansen, John; Timbol, Julius; Lewis, Ned; Istúriz, Raúl; Alexander-Parrish, Ronika; McLaughlin, John M.; Gessner, Bradford D.; Klein, Nicola P.

doi:10.1001/jamanetworkopen.2022.1111

Cited by 35 publications

(26 citation statements)

References 49 publications

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“…However, the 28-day mortality rate in HAP in the present study was comparable with those of other related studies ranging from 28.7 to 44.4% 25 , 26 , 42 . Therefore, vaccinations for some specific pathogens such as influenza, S. pneumoniae is a major preventive strategy for pneumonia acquired in a community setting and plays an essential role in reducing incidence and mortality 43 – 45 . In addition, minimizing hospital length of stay is an effective method to lower HAP incidence 46 .…”

Section: Discussionmentioning

confidence: 99%

Bacterial etiology and mortality rate in community-acquired pneumonia, healthcare-associated pneumonia and hospital-acquired pneumonia in Thai university hospital

Poovieng

Sakboonyarat

Nasomsong

2022

Sci Rep

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Pneumonia is caused by infection at the pulmonary parenchyma which constitutes a crucial risk factor for morbidity and mortality. We aimed to determine the mortality rate and its risk factors as well as etiology among inpatients with community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP) and healthcare-associated pneumonia (HCAP). A hospital-based retrospective cohort study was conducted in a university hospital located in Bangkok, Thailand. A total of 250 inpatients with pneumonia was included in the present study. The inhospital mortality rate was 1.25 (95% CI 0.99–1.56) per 100 person-days. The present study reported that overall pneumonia caused by gram-negative pathogens accounted for 60.5%. P. aeruginosa was a frequent gram-negative pathogen among these participants, especially among patients with HCAP and HAP. Adjusted hazard ratio (AHR) of inhospital mortality among patients with HAP was 1.75 (95% CI 1.01–3.03) times that of those among patients with CAP, while AHR for 28-day mortality among patients with HAP compared with those with CAP was 2.81 (95% CI 1.38–5.75). Individual risks factors including cardiomyopathy, active-smoker and insulin use were potential risk factors for mortality. Initial qSOFA and acid-based disturbance should be assessed to improve proper management and outcomes.

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Section: Discussionmentioning

confidence: 99%

Bacterial etiology and mortality rate in community-acquired pneumonia, healthcare-associated pneumonia and hospital-acquired pneumonia in Thai university hospital

Poovieng

Sakboonyarat

Nasomsong

2022

Sci Rep

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“…PCVs were subsequently developed to provide an effective immunization option for young children [ 13 ]. In 2010, the Food and Drug Administration (FDA) approved PCV13 for use in children and in 2012 expanded the indication to adults age >50 years [ 13 ], resulting in significant reductions in hospitalizations for pneumonia and lower respiratory tract infections in adults over 65 years of age [ 16 ]. The latest PCVs, which were approved by the FDA in 2021 for adults 18 years of age or older, provide broader serotype coverage (PCV15 [ 17 ] and PCV20 [ 18 ]).…”

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confidence: 99%

A Multicenter Evaluation of Trends in Antimicrobial Resistance Among Streptococcus pneumoniae Isolates From Adults in the United States

Mohanty

Johnson

Watts

et al. 2022

Open Forum Infectious Diseases

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Background Management of pneumococcal disease is complicated by high rates of antimicrobial resistance (AMR). This study assessed AMR trends for Streptococcus pneumoniae isolates from adults with pneumococcal disease. Methods From January 2011 to February 2020, we evaluated 30-day non-duplicate S. pneumoniae isolates from 290 US hospitals (BD Insights Research Database) from adults (≥ 18 years) in inpatient and outpatient settings. Isolates were required to have at least one AMR result for invasive (blood, cerebrospinal fluid/neurologic) or non-invasive (respiratory or ear/nose/throat) pneumococcal disease samples. Determination of AMR was based on facility reports of intermediate or resistant. Descriptive statistics and generalized estimated equations were used to assess variations over time. Results Over the study period, 34,039 S. pneumoniae isolates were analyzed (20,749 [61%] from non-invasive sources and 13,290 [39%] from invasive sources). Almost half (46.6%) of the isolates were resistant to ≥ 1 drug and non-invasive isolates had higher rates of AMR than invasive isolates. Total S. pneumoniae isolates had high rates of resistance to macrolides (37.7%), penicillin (22.1%), and tetracyclines (16.1%). Multivariate modeling identified a significant increasing trend in resistance to macrolides (+1.8%/year; P < 0.001). Significant decreasing trends were observed for penicillin (-1.6%/year; P < 0.001), extended-spectrum cephalosporins (ESCs) (-0.35%/year; P < 0.001), and ≥3 drugs (-0.5%/year; P < 0.001). Conclusions Despite decreasing trends for penicillin, ESCs, and resistance to ≥3 drugs, AMR rates are persistently high in S. pneumoniae isolates among US adults. Increasing macrolide resistance suggests that efforts to address AMR in S. pneumoniae may require antimicrobial stewardship efforts and higher-valent pneumococcal conjugate vaccines.

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“…[29] We also note that the findings presented herein likely underestimate the impact of PCV20 use among adults in Germany because multiple studies evaluating the impact of PCV13 against all-cause CAP have reported larger reductions than what would be expected if accounting only for etiologically confirmed vaccine-type pneumonia. [54][55][56] Some recently published real-world data analyses suggest that PPV23 may provide limited protection against VT-CAP, but because there is considerable inconsistency across studies, we do not believe these data are sufficiently robust to employ in base case analyses. [30,32,38,39,57] Nonetheless, we conducted scenario analyses that assumed moderate PPV23 effectiveness against VT-CAP based on findings from Lawrence et al and Suzuki et al, respectively.…”

Section: Discussionmentioning

confidence: 96%

Cost-effectiveness of use of 20-valent pneumococcal conjugate vaccine among adults in Germany

Kuehne

Achtert²,

Pueschner³

et al. 2023

Preprint

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Objectives. Despite national recommendations for use of pneumococcal vaccines, rates of community-acquired pneumonia (CAP) and invasive pneumococcal disease (IPD) remain high in Germany. New pneumococcal conjugate vaccines (PCVs) with expanded coverage have the potential to reduce the pneumococcal disease burden among adults. Methods. Using a Markov model, we evaluated the lifetime outcomes/costs comparing 20-valent PCV (PCV20) with standard of care (SC) vaccination for prevention of CAP and IPD among adults aged 60 years and at-risk adults aged 18-59 years in Germany. PCV20 also was compared with sequential vaccination with 15-valent PCV (PCV15) followed by PPV23 in a scenario analysis. Results. Use of PCV20 vs. SC would prevent 54,333 hospitalizations, 26,368 outpatient CAP cases, 10,946 disease-related deaths yield 74,694 additional life-years (LYs), while lowering total medical costs by 363.2M Euro. PCV20 was cost saving (i.e., dominant) versus SC. Scenario analysis results suggest that the use of PCV20 would also prevent more cases and deaths, yield more LYs, and result in lower costs than using PCV15→PPV23. Conclusions. One dose of PCV20 among adults aged 60 years and adults aged 18-59 years with moderate- and high-risk conditions would substantially reduce pneumococcal disease, save lives, and be cost saving compared with SC.

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Incidence and Estimated Vaccine Effectiveness Against Hospitalizations for All-Cause Pneumonia Among Older US Adults Who Were Vaccinated and Not Vaccinated With 13-Valent Pneumococcal Conjugate Vaccine

Cited by 35 publications

References 49 publications

Bacterial etiology and mortality rate in community-acquired pneumonia, healthcare-associated pneumonia and hospital-acquired pneumonia in Thai university hospital

Bacterial etiology and mortality rate in community-acquired pneumonia, healthcare-associated pneumonia and hospital-acquired pneumonia in Thai university hospital

A Multicenter Evaluation of Trends in Antimicrobial Resistance Among Streptococcus pneumoniae Isolates From Adults in the United States

Cost-effectiveness of use of 20-valent pneumococcal conjugate vaccine among adults in Germany

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