Case-fatality rate of invasive pneumococcal disease caused by various serotypes - an analysis of nationwide surveillance data from Israel, 2009-2018.

IF 10.9 1区医学 Q1 INFECTIOUS DISEASES Clinical Microbiology and Infection Pub Date : 2024-11-15 DOI:10.1016/j.cmi.2024.11.018

Anat Wieder-Finesod, Dafna Yahav, Carmit Rubin, Shirley Hashkor, Jo Southern, Gabriel Mircus, Christian Theilacker, Ron Dagan, Gili Regev-Yochay

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Abstract

Objectives: The 20-valent pneumococcal conjugate vaccine (PCV20) has been introduced in Israel. Its public health benefit depends on its effect on mortality caused by PCV20 serotypes not present in PCV13 (PCV20non13). We aimed to describe invasive pneumococcal disease (IPD) characteristics and case fatality rate among adults by serotypes.

Methods: We analysed data from the Israeli nationwide surveillance database of IPD in adults, 2009-2018. The primary outcome was in-hospital case fatality rate (CFR) within 30 days, focusing on specific serotypes. Adjusted odds ratios (aORs) for association between PCV20non13 serotypes and mortality were calculated using logistic regression.

Results: Overall, 3864 IPD episodes were reported, 3733 (96.6%) with known serotype, 54% (1705/3123) were in men; 54% (1997/3733) were aged ≥65 years. PCV13-IPD cases constituted 40% of all IPD and decreased during study years. PCV20non13 and nonPCV20 serotypes constituted 26% and 34% of cases, respectively, and increased over time. The most frequent non-PCV13 serotypes detected were PCV20non13 serotypes 8 (8%), 12F (7.2%), 22F (3%); and nonPCV20 serotype 16F (5%). In-hospital CFR was 22% (698/3140). CFR for PCV13 serotype was 21.1% (265/1255); for PCV20non13 - 16.2% (124/766); and for nonPCV20 CFR - 28.5% (289/1014). Among PCV20non13 serotypes compared to PCV13 serotypes, 11A was associated with higher CFR (41%, aOR 3.1, 95% CI 1.64-5.83), while serotype 8 was associated with lower CFR (8%, aOR 0.5, 95% CI 0.3-0.8).

Conclusions: PCV20non13 serotypes constituted 26% of all adult IPD in the post-PCV13 era. CFR from PCV20non13 serotype IPD was comparable to that from PCV13 serotypes. These data support the potential added benefit of PCV20 in reducing mortality from IPD, though mortality remains substantial from nonPCV20 serotypes. Future IPD-related mortality will depend on the evolution of serotype distribution over time.

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各种血清型引起的侵袭性肺炎球菌疾病的病死率--2009-2018 年以色列全国监测数据分析。

目的：以色列已引入 20 价肺炎球菌结合疫苗 (PCV20)。它对公共卫生的益处取决于它对 PCV20 血清型（PCV20non13）所导致的死亡率的影响。我们旨在按血清型描述侵入性肺炎球菌疾病（IPD）的特征和成人病死率：我们分析了 2009-2018 年以色列全国成人 IPD 监测数据库中的数据。主要结果是30天内的院内病例死亡率（CFR），重点是特定血清型。采用逻辑回归法计算 PCV20non13 血清型与死亡率之间的调整后几率比（aORs）：共报告了 3864 例 IPD 病例，其中 3733 例（96.6%）有已知血清型，54%（1705/3123）为男性；54%（1997/3733）年龄≥65 岁。PCV13-IPD 病例占所有 IPD 病例的 40%，在研究期间有所下降。PCV20-non13和非PCV20血清型分别占病例总数的26%和34%，并随着时间的推移而增加。最常检测到的非 PCV13 血清型为 PCV20non13 血清型 8（8%）、12F（7.2%）、22F（3%）和非 PCV20 血清型 16F（5%）。院内 CFR 为 22%（698/3140）。PCV13 血清型的 CFR 为 21.1%（265/1255）；PCV20non13 血清型的 CFR 为 16.2%（124/766）；非 PCV20 血清型的 CFR 为 28.5%（289/1014）。与 PCV13 血清型相比，PCV20non13 血清型中 11A 与较高的 CFR 相关（41%，aOR 3.1，95% CI 1.64-5.83），而血清型 8 与较低的 CFR 相关（8%，aOR 0.5，95% CI 0.3-0.8）：结论：后 PCV13 时代，PCV20 非 13 血清型占所有成人 IPD 的 26%。PCV20non13 血清型 IPD 的 CFR 与 PCV13 血清型相当。这些数据支持 PCV20 在降低 IPD 死亡率方面的潜在额外益处，尽管非 PCV20 血清型的 IPD 死亡率仍然很高。未来与 IPD 相关的死亡率将取决于血清型分布随时间的变化。

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来源期刊

Clinical Microbiology and Infection 医学-传染病学

CiteScore

25.30

自引率

2.10%

发文量

441

审稿时长

2-4 weeks

期刊介绍： Clinical Microbiology and Infection (CMI) is a monthly journal published by the European Society of Clinical Microbiology and Infectious Diseases. It focuses on peer-reviewed papers covering basic and applied research in microbiology, infectious diseases, virology, parasitology, immunology, and epidemiology as they relate to therapy and diagnostics.