Invasive pneumococcal disease among adults with hematological and solid organ malignancies: A population-based cohort study

Garrido, Hannah M. Garcia; Knol, Mirjam J.; Heijmans, Jarom; Sorge, Nina M. van; Sanders, Elisabeth A. M.; Klümpen, Heinz Josef; Grobusch, Martin P.; Goorhuis, Abraham

doi:10.1016/j.ijid.2021.03.072

Cited by 15 publications

(17 citation statements)

References 31 publications

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“…The percentage of IPD cases with underlying comorbidities changes over time [ 9 , 10 ], making comparisons between previous and more recent studies difficult. The number of cases in specific high-risk groups in our data were too small to do meaningful calculations, but our results are overall consistent with other studies reporting a marked increased risk of IPD among those with certain clinical conditions, such as haematological cancer, generalised malignancies and solid organ transplants [ 30 , 31 , 32 ].…”

Section: Discussionsupporting

confidence: 90%

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

et al. 2021

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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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Section: Discussionsupporting

confidence: 90%

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

et al. 2021

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“…This study highlights potentially missed opportunities when caring for patients presenting with invasive infections, throughout all stages of patient care, pre- and postinfection. While also highlighting the burden of invasive airway pathogen infections within an Australian setting, it confirms the potential for underlying primary immunodeficiencies, as well as secondary immunodeficiencies as common predispositions, particularly solid organ and hematological malignancies, in keeping with previous studies [ 29 ].…”

Section: Discussionsupporting

confidence: 84%

Missed Opportunities? A Retrospective Study Into Adults Hospitalized With Invasive Infection From Airway Pathogens

Smith

Tan

Bastas

et al. 2022

Open Forum Infectious Diseases

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Background Invasive disease caused by airway pathogens, including Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, and Moraxella catarrhalis, has high morbidity and mortality worldwide, with immunodeficiency being a known association with recurrent disease. The study aimed to describe the frequency of known immunodeficiency and predisposing factors in adult patients presenting with invasive infections and determine the frequency of screening for and detection of immunodeficiency. Methods A retrospective analysis was conducted at a large tertiary Australian health service, comprising multiple centers. Patients aged 18 years or older, in whom the above pathogens were isolated from sterile sites, were included as identified through a microbiology database, between 2015 and 2020. Using electronic medical records, patient demographics, medical history, outcomes of admission, and pathology results were captured and reviewed to address the aims. Results In 252 patients, S pneumoniae was the most common culprit, isolated in 73% (185/252), compared to 14.3% (36/252) and 11.5% (29/252) of infections caused by H influenzae and N meningitidis, respectively. Known diagnoses of secondary immunodeficiency were common (31% of patients). Of those presenting with invasive pneumococcal disease, 78% had at least 1 predisposing condition, though only 9 patients (6%) had previously received pneumococcal vaccination. Despite poor screening for immunodeficiency, 12 new diagnoses were made. While the commonest immunodeficiency was secondary, due to hematological and solid organ malignancies, 3 new primary immunodeficiency diagnoses were made. Conclusions Immunodeficiency is common in this patient population. Screening should be undertaken to ensure timely diagnosis and treatment of the underlying condition to avoid future morbidity and mortality.

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“…Alternatively, to improve the response to PPSV23 serotypes, the PPSV23 dose could be postponed, as serologic response rates to PPSV23 serotypes were higher in a study in which PPSV23 was administered >22 months after allo‐HSCT 2 . However, this strategy would leave allo‐HSCT recipients unprotected against the most commonly circulating pneumococcal serotypes to date 6–8 …”

Section: Discussionmentioning

confidence: 99%

“… 2 However, this strategy would leave allo‐HSCT recipients unprotected against the most commonly circulating pneumococcal serotypes to date. 6 , 7 , 8…”

Section: Discussionmentioning

confidence: 99%

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Immunogenicity of a 5‐dose pneumococcal vaccination schedule following allogeneic hematopoietic stem cell transplantation

et al. 2022

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The optimal schedule of pneumococcal vaccination after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains controversial. The objective of this study was to investigate the immunogenicity of a 5-dose pneumococcal vaccination schedule in adult allo-HSCT recipients with and without immunosuppressive therapy.In this prospective cohort study, allo-HSCT recipients received four doses of the 13-valent pneumococcal conjugate vaccine (PCV13) and one dose of the 23-valent pneumococcal polysaccharide vaccine (PPSV23) starting 4-6 months after allo-HSCT.

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Invasive pneumococcal disease among adults with hematological and solid organ malignancies: A population-based cohort study

Cited by 15 publications

References 31 publications

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

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

Missed Opportunities? A Retrospective Study Into Adults Hospitalized With Invasive Infection From Airway Pathogens

Immunogenicity of a 5‐dose pneumococcal vaccination schedule following allogeneic hematopoietic stem cell transplantation

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