Gertjan H J Wagenvoort1, Mirjam J Knol2, Hester E de Melker2, Bart J Vlaminckx3, Arie van der Ende4, Mark H Rozenbaum5, Elisabeth A M Sanders6. 1. Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands. Electronic address: wagenvoort@gmail.com. 2. Centre for Infectious Disease Control Netherlands (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. 3. Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands. 4. Department of Medical Microbiology and The Netherlands Reference Laboratory for Bacterial Meningitis, Academic Medical Center, Amsterdam, The Netherlands. 5. Pfizer bv., RiviumWestlaan 142, 2909 LD Capelle a/d IJssel, The Netherlands; Department of Pharmacy, Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), University of Groningen, Groningen, The Netherlands. 6. Centre for Infectious Disease Control Netherlands (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Immunology and Infectious Diseases, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Abstract
BACKGROUND: Immunocompromising conditions and advanced age (≥65 years) are associated with a high risk for invasive pneumococcal disease (IPD). We investigated the risk and outcomes of IPD in adults with underlying conditions in the post-PCV7 era in The Netherlands. METHODS: IPD data from 2008 to 2012 was obtained from the national pneumococcal surveillance system, covering 25% of the Dutch population. Population estimates of underlying conditions were derived from the primary care data (2012). IPD incidence in adults with immunocompromising conditions (high risk group) and non-immunocompromising comorbidities (medium risk group) were compared to the "normal risk group" without diagnosed comorbidities. Case-fatality and ICU admission in the different risk groups was analyzed by logistic regression. Serotype specific propensities to affect high risk group IPD patients were calculated. RESULTS: Adults with a high risk condition have a 18-fold (95% CI 15.6-21.2) and 3-fold (95% CI 2.6-3.9) higher risk compared to the normal risk group for IPD at age 18-64 years and 65 years and older, respectively. In case of a medium risk condition, the risk is 5-fold (95% CI 4.3-5.7) and 2-fold (95% CI 1.9-2.6) higher in age groups 18-64 and ≥65 years old. Likewise, IPD patients with a high or medium risk condition have a higher case-fatality (after adjustment for age, odds ratio: 2-fold (95% CI 1.5-3.5) and 1.4-fold (95% CI 1.0-2.1), respectively). Several serotypes (e.g. 6A, 6B, 23A and 23B) are associated with a significantly higher propensity to cause disease in high risk patients. CONCLUSIONS: The risk for IPD and death in the post-PCV7 era has remained considerably high in adults and elderly with underlying conditions. The identification of serotypes with a high propensity to affect risk groups can be important for selecting (future) vaccine serotypes.
BACKGROUND: Immunocompromising conditions and advanced age (≥65 years) are associated with a high risk for invasive pneumococcal disease (IPD). We investigated the risk and outcomes of IPD in adults with underlying conditions in the post-PCV7 era in The Netherlands. METHODS: IPD data from 2008 to 2012 was obtained from the national pneumococcal surveillance system, covering 25% of the Dutch population. Population estimates of underlying conditions were derived from the primary care data (2012). IPD incidence in adults with immunocompromising conditions (high risk group) and non-immunocompromising comorbidities (medium risk group) were compared to the "normal risk group" without diagnosed comorbidities. Case-fatality and ICU admission in the different risk groups was analyzed by logistic regression. Serotype specific propensities to affect high risk group IPD patients were calculated. RESULTS: Adults with a high risk condition have a 18-fold (95% CI 15.6-21.2) and 3-fold (95% CI 2.6-3.9) higher risk compared to the normal risk group for IPD at age 18-64 years and 65 years and older, respectively. In case of a medium risk condition, the risk is 5-fold (95% CI 4.3-5.7) and 2-fold (95% CI 1.9-2.6) higher in age groups 18-64 and ≥65 years old. Likewise, IPD patients with a high or medium risk condition have a higher case-fatality (after adjustment for age, odds ratio: 2-fold (95% CI 1.5-3.5) and 1.4-fold (95% CI 1.0-2.1), respectively). Several serotypes (e.g. 6A, 6B, 23A and 23B) are associated with a significantly higher propensity to cause disease in high risk patients. CONCLUSIONS: The risk for IPD and death in the post-PCV7 era has remained considerably high in adults and elderly with underlying conditions. The identification of serotypes with a high propensity to affect risk groups can be important for selecting (future) vaccine serotypes.
Authors: Hannah M Garcia Garrido; Anne M R Mak; Ferdinand W N M Wit; Gino W M Wong; Mirjam J Knol; Albert Vollaard; Michael W T Tanck; Arie Van Der Ende; Martin P Grobusch; Abraham Goorhuis Journal: Clin Infect Dis Date: 2020-06-24 Impact factor: 9.079
Authors: Emily Mosites; Tammy Zulz; Dana Bruden; Leisha Nolen; Anna Frick; Louisa Castrodale; Joseph McLaughlin; Chris Van Beneden; Thomas W Hennessy; Michael G Bruce Journal: Emerg Infect Dis Date: 2019-10 Impact factor: 6.883
Authors: Bob Meek; Nina Ekström; Bjørn Kantsø; Rachael Almond; Jamie Findlow; Jenna F Gritzfeld; Charlotte Sværke Jørgensen; Karl Ljungberg; Fredrik Atterfelt; Manou R Batstra; Kevin Andeweg; Ben A W de Jong; Harry E Prince; Mary Lapé-Nixon; Pieter G M Gageldonk; Irina Tcherniaeva; Ingeborg Aaberge; Tove Karin Herstad; Merit Melin; Ger T Rijkers; Guy A Berbers Journal: mSphere Date: 2019-11-27 Impact factor: 4.389