Effect of Age on the Manifestations and Outcomes of Invasive Pneumococcal Disease in Adults - 08/12/17
, Gregory J. Tyrrell, PhD b, Sumit R. Majumdar, MD c, Dean T. Eurich, PhD dAbstract |
Background |
Although a considerable amount is known about the effect of age on the manifestations and outcomes of pneumonia, the same is not true for invasive pneumococcal disease.
Methods |
This was a prospective observational study of all cases (2435) of invasive pneumococcal disease in adults in Northern Alberta from 2000 to 2014. Rates of invasive pneumococcal disease per 100,000, sociodemographic variables, clinical characteristics, and invasive pneumococcal disease–related outcomes were compared for the following age groups: 17-54, 55-64, 65-74, and ≥75 years.
Results |
The rate of invasive pneumococcal disease per 100,000 increased with increasing age. Although only 27.3% of the cases were in those aged ≥65 years, they accounted for 48% of the deaths. The case fatality rate increased with increasing age, from 9.6% for those aged 17-54 years to 31.7% for those aged ≥75 years. The rate of meningitis decreased with increasing age, as did admission to intensive care and use of mechanical ventilation. There was a marked reduction in the rate of invasive pneumococcal disease due to protein conjugate vaccine 7 and protein conjugate vaccine 13 serotypes in those aged ≥55 years but a much smaller decline in rates for those aged 17-54 years. Replacement with non-vaccine serotypes constituted approximately 50% of the cases.
Conclusions |
The rate of invasive pneumococcal disease is highest in the very elderly, and manifestations of invasive pneumococcal disease are influenced by age.
Le texte complet de cet article est disponible en PDF.Keywords : Age group, Invasive pneumococcal disease, Streptococcus pneumoniae
Plan
| Funding: This study was supported by a grant-in-aid from Pfizer, Canada and Merck Canada Inc. The funders had no role in the design of the study or data analysis and they have not seen the manuscript. SRM holds the Endowed Chair in Patient Health Management supported by the Faculties of Medicine and Dentistry and Pharmacy and Pharmaceutical Sciences at the University of Alberta. DTE is a Canada Research Chair supported by the Government of Canada. |
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| Conflict of Interest: Other than the above 2 research grants—none. |
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| Authorship: TJM and GJT designed the study, organized the data collection, and had full access to all of the data in the study. DTE conducted all analyses and had full access to the data. All authors contributed to the interpretation of data, wrote the manuscript, revised the manuscript for intellectual content, and approved the manuscript to be published. |
Vol 131 - N° 1
P. 100.e1-100.e7 - janvier 2018 Retour au numéro
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