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  1. Article ; Online: Epidemiología de la neumonía neumocócica en adultos mayores de 50 años: estudio de cohortes en Cataluña, 2017-2018.

    Ochoa-Gondar, Olga / Torras-Vives, Verónica / de Diego-Cabanes, Cinta / Satué Gracia, Eva / Forcadell-Peris, María José / Vila-Córcoles, Ángel

    Atencion primaria

    2023  Volume 55, Issue 7, Page(s) 102631

    Abstract: Objective: To analyse population-based incidence and lethality of pneumococcal pneumonia (PP) requiring hospitalisation among Catalonian adults after universal vaccination implementation in infants.: Design: Population-based cohort study.: Setting!# ...

    Title translation Epidemiology of pneumococcal pneumonia among middle-aged and older adults in Catalonia, 2017-2018.
    Abstract Objective: To analyse population-based incidence and lethality of pneumococcal pneumonia (PP) requiring hospitalisation among Catalonian adults after universal vaccination implementation in infants.
    Design: Population-based cohort study.
    Setting: Primary care/hospital, Catalonia.
    Participants: 2,059,645 individuals ≥50 years old affiliated to the Institut Catala de la Salut retrospectively followed between 01/01/2017 and 31/12/2018.
    Main outcome measures: The Catalonian information system for the development of research in primary care (SIDIAP, Sistema de Información para el Desarrollo de la Investigación en Atención Primaria) was used to establish baseline characteristics and risk-strata of cohort members at study start: low-risk (immunocompetent persons without risk conditions), intermediate-risk (immunocompetent persons with at-risk condition) and high-risk (immunocompromising conditions). PP requiring hospitalisation among cohort members across study period were collected from CMBD (Conjunto Mínimo Básico de Datos) discharge data of 64 reference Catalonian hospitals.
    Results: An amount of 3592 episodes of HPP were observed, with an incidence density of 90.7 cases per 100,000 person-years (95% CI: 85.2-96.5), being 11.9 bacteremic (95% CI: 10.8-13.1) and 78.8 non-bacteremic (95% CI: 74.0-83.8). Incidence rates substantially increased by age (37.3 in 50-64 years vs. 98.3 in 65-79 years vs. 259.8 in ≥80 years) and baseline-risk stratum (42.1, 120.7 and 238.6 in low-, intermediate- and high-risk stratum, respectively). Overall case-fatality rate was 7.6% (10.8% in invasive cases vs. 7.1% in non-invasive cases; pP=.004). In multivariable analyses, high-risk stratum and oldest age were the strongest predictors for invasive and non-invasive cases, respectively.
    Conclusion: Incidence and lethality of PP remained moderate among adults >50 years in Catalonia during 2017-2018 (earlier period after universal vaccination introduction for infants).
    MeSH term(s) Middle Aged ; Humans ; Aged ; Pneumonia, Pneumococcal/epidemiology ; Pneumonia, Pneumococcal/prevention & control ; Cohort Studies ; Retrospective Studies ; Spain/epidemiology ; Hospitalization ; Incidence
    Language Spanish
    Publishing date 2023-04-27
    Publishing country Spain
    Document type English Abstract ; Journal Article
    ZDB-ID 1200787-0
    ISSN 1578-1275 ; 0212-6567
    ISSN (online) 1578-1275
    ISSN 0212-6567
    DOI 10.1016/j.aprim.2023.102631
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Evaluating clinical effectiveness and impact of anti-pneumococcal vaccination in adults after universal childhood PCV13 implementation in Catalonia, 2017-2018.

    Vila-Córcoles, Angel / Ochoa-Gondar, Olga / de Diego-Cabanes, Cinta / Satué-Gracia, Eva M / Torras-Vives, Verónica / Forcadell-Peris, M José / Ribas-Seguí, Domingo / Vila-Rovira, Angel / Rodríguez-Casado, Clara

    Vaccine: X

    2023  Volume 13, Page(s) 100264

    Abstract: Background: At present, because of indirect effects derived from routine childhood immunisation, clinical benefits vaccinating adults with the 23-valent pneumococcal polysaccharide vaccine (PPsV23) and/or the 13-valent pneumococcal conjugate vaccine ( ... ...

    Abstract Background: At present, because of indirect effects derived from routine childhood immunisation, clinical benefits vaccinating adults with the 23-valent pneumococcal polysaccharide vaccine (PPsV23) and/or the 13-valent pneumococcal conjugate vaccine (PCV13) are uncertain. This study investigated clinical effectiveness for both PPsV23/PCV13 in preventing pneumonia among Catalonian adults during an earlier 2-year period post-PCV13 free (publicly funded) approval for infants.
    Methods: We conducted a Population-based cohort study involving 2,059,645 adults ≥ 50 years in Catalonia, Spain, who were followed between 01/01/2017-31/12/2018. Primary outcomes were hospitalisation from pneumococcal pneumonia (PP) or all-cause pneumonia (ACP) and main explanatory variable was PCV13/PPsV23 vaccination status. Cox regression models were used to estimate vaccination effectiveness adjusted by age/sex and underlying-risk conditions.
    Results: Cohort members were followed for 3,958,528 person-years (32,328 PCV13-vaccinated, 1,532,186 PPsV23-vaccinated), observing 3592 PP (131 in PCV13-vaccinated vs 2476 in PPsV23-vaccinated) and 24,136 ACP (876 in PCV13-vaccinated vs 17,550 in PPsV23-vaccinated). Incidence rates (per 100,000 person-years) were 90.7 for PP (394.2 in PCV13-vaccinated vs 161.6 in PPsV23-vaccinated) and 609.7 for ACP (2636.3 in PCV13-vaccinated vs 1145.4 in PPsV23-vaccinated). The PCV13 was associated with an increased risk of PP (hazard ratio [HR]: 1.24; 95% CI: 1.00-1.52; p = 0.046) and ACP (HR: 1.38; 95% CI: 1.28-1.49; p < 0.001) whereas the PPsV23 did not alter the risk of PP (HR: 1.07; 95% CI: 0.98-1.18; p = 0.153) and slightly increased the risk of ACP (HR: 1.14; 95% CI: 1.10-1.18; p < 0.001). In supplementary analyses focused on at-risk individuals (i.e., elderly persons, immunocompromissing and other chronic illnesses) protective effects of vaccination did not emerge either.
    Conclusions: Data does not support clinical benefits from pneumococcal vaccination (nor PCV13 neither PPsV23) against pneumonia among Catalonian middle-aged and older adults in the current era of universal PCV13 childhood immunisation in our setting. New extended valency PCVs are greatly needed.
    Language English
    Publishing date 2023-01-21
    Publishing country England
    Document type Journal Article
    ISSN 2590-1362
    ISSN (online) 2590-1362
    DOI 10.1016/j.jvacx.2023.100264
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Incidence and risk factors of pneumococcal pneumonia in adults: a population-based study.

    Ochoa-Gondar, Olga / Torras-Vives, Verónica / de Diego-Cabanes, Cinta / Satué-Gracia, Eva M / Vila-Rovira, Angel / Forcadell-Perisa, María J / Ribas-Seguí, Domingo / Rodríguez-Casado, Clara / Vila-Córcoles, Angel

    BMC pulmonary medicine

    2023  Volume 23, Issue 1, Page(s) 200

    Abstract: Background: Infection caused by Streptococcus pneumoniae, mainly invasive pneumococcal disease (IPD) and pneumococcal pneumonia (PP), are a major public health problem worldwide. This study investigated population-based incidence and risk of PP among ... ...

    Abstract Background: Infection caused by Streptococcus pneumoniae, mainly invasive pneumococcal disease (IPD) and pneumococcal pneumonia (PP), are a major public health problem worldwide. This study investigated population-based incidence and risk of PP among Catalonian persons ≥ 50 years-old with and without specific underlying conditions/comorbidities, examining the influence of single and multi-comorbidities in the risk of suffering PP.
    Methods: Population-based cohort study involving 2,059,645 persons ≥ 50 years-old in Catalonia, Spain, who were retrospectively followed between 01/01/2017-31/12/2018. The Catalonian information system for development of research in primary care (SIDIAP) was used to establish baseline characteristics of the cohort (comorbidities/underlying conditions), and PP cases were collected from discharge codes (ICD-10: J13) of the 68 referral Catalonian hospitals.
    Results: Global incidence rate (IR) was 90.7 PP cases per 100,000 person-years, with a 7.6% (272/3592) case-fatality rate (CFR). Maximum IRs emerged among persons with history of previous IPD or all-cause pneumonia, followed by haematological neoplasia (475.0), HIV-infection (423.7), renal disease (384.9), chronic respiratory disease (314.7), liver disease (232.5), heart disease (221.4), alcoholism (204.8), solid cancer (186.2) and diabetes (159.6). IRs were 42.1, 89.9, 201.1, 350.9, 594.3 and 761.2 in persons with 0, 1, 2, 3, 4 and ≥ 5 comorbidities, respectively. In multivariable analyses, HIV-infection (hazard ratio [HR]: 5.16; 95% CI: 3.57-7.46), prior all-cause pneumonia (HR: 3.96; 95% CI: 3.45-4.55), haematological neoplasia (HR: 2.71; 95% CI: 2.06-3.57), chronic respiratory disease (HR: 2.66; 95% CI: 2.47-2.86) and prior IPD (HR: 2.56; 95% CI: 2.03-3.24) were major predictors for PP.
    Conclusion: Apart of increasing age and immunocompromising conditions (classically recognised as high-risk conditions), history of prior IPD/pneumonia, presence of chronic pulmonary/respiratory disease and/or co-existing multi-comorbidity (i.e., two or more underlying conditions) are major risk factors for PP in adults, with an excess risk near to immunocompromised subjects. Redefining risk categories for PP, including all the above-mentioned conditions into the high-risk category, could be necessary to improve prevention strategies in middle-aged and older adults.
    MeSH term(s) Middle Aged ; Humans ; Aged ; Pneumonia, Pneumococcal/epidemiology ; Pneumonia, Pneumococcal/prevention & control ; Incidence ; Cohort Studies ; Retrospective Studies ; Risk Factors ; Pneumococcal Infections/epidemiology ; Neoplasms/complications ; Pneumococcal Vaccines
    Chemical Substances Pneumococcal Vaccines
    Language English
    Publishing date 2023-06-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2059871-3
    ISSN 1471-2466 ; 1471-2466
    ISSN (online) 1471-2466
    ISSN 1471-2466
    DOI 10.1186/s12890-023-02497-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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