2010 - 2012年波兰Chrzanów县老年人社区获得性肺炎肺炎链球菌负担的前瞻性人群监测

Rafal Harat, Ronika Alexander, Sharon Gray, Elane M Gutterman, Justyna Pluta, Michael Pride, Sebastian Shite, Joanna Fijolek, Jolanta Kozub
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引用次数: 3

摘要

由肺炎链球菌引起的社区获得性肺炎(CAP)是老年人发病和死亡的重要原因。该研究估计了居住在波兰Chrzanów县的46,000名年龄≥50岁的高危成人中CAP、胸片确诊CAP (CXR+CAP)、S型肺炎阳性CAP、S型肺炎阳性CXR+CAP和肺炎链球菌血清型分布的发病率。材料和方法:2010年1月至2012年1月,所有提供门诊和住院护理的机构招募了所有同意怀疑有CAP的住院患者。对胸片、尿液、血液和痰样本进行分析。确定年化发病率。采用尿抗原检测法(能够检测13价肺炎球菌结合疫苗[PCV13]的血清型)、BinaxNOW®和/或微生物培养确定肺炎链球菌阳性CAP的存在和/或肺炎链球菌血清型分布。结果:在5055例入组患者中,1195例(23.7%)诊断为CAP, 1166例(23.4%)诊断为CXR+CAP。在CAP组和CXR+CAP组分别检测到144例(12.1%)和131例(11.2%)肺炎链球菌。CAP、CXR+CAP、S型肺炎阳性CAP和S型肺炎阳性CXR+CAP的年化发病率分别为12.8、12.5、1.6和1.4 / 1000居民。在CXR+CAP患者中,39.7%的患者年龄在50 ~ 64岁之间,60.3%的患者年龄≥65岁。发病率一般随年龄增长而增加。肺炎链球菌阳性CXR+CAP患者中最常见的血清型为3型(n = 15)、23F型(n = 10)、18C型(n = 9)和9V型(n = 6)。结论:PCV13血清型引起的CAP是50岁以上成年人发病的一个来源,并且可以通过更多地获得肺炎球菌疫苗来减少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prospective, population-based surveillance of the burden of Streptococcus pneumoniae in community-acquired pneumonia in older adults, Chrzanów County, Poland, 2010 to 2012.

Introduction: Community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae is a substantial cause of morbidity and mortality among older adults. This study estimated incidences of CAP, chest x-ray-confirmed CAP (CXR+CAP), S pneumonia- positive CAP, S pneumonia-positive CXR+CAP, and S. pneumoniae serotype distribution among 46,000 at-risk adults aged ≥ 50 years residing in Chrzanów County, Poland.

Material and methods: From January 2010 to January 2012, all facilities providing ambulatory and inpatient care enrolled all consenting resident patients with suspicion of CAP. Chest x-rays, urine, blood, and sputum samples were analyzed. Annualized incidence rates were determined. Presence of S pneumonia-positive CAP and/or S. pneumoniae serotype distribution was determined using the urine antigen detection assay (capable of detecting the serotypes in the 13-valent pneumococcal conjugate vaccine [PCV13]), BinaxNOW®, and/or microbiology cultures.

Results: Among 5055 enrolled patients, 1195 (23.7%) were diagnosed with CAP and 1166 (23.4%) had CXR+CAP. S. pneumoniae was detected in 144 (12.1%) and 131 (11.2%) patients from the CAP and CXR+CAP cohorts, respectively. Annualized incidence rates of CAP, CXR+CAP, S pneumonia-positive CAP, and S. pneumonia-positive CXR+CAP were 12.8, 12.5, 1.6, and 1.4 per 1000 residents, respectively. Among CXR+CAP patients, 39.7% were aged 50 to 64 years and 60.3% were aged ≥ 65 years. Incidence rates generally increased with age. The most common serotypes in S. pneumoniae-positive CXR+CAP patients were 3 (n = 15), 23F (n = 10), 18C (n = 9), and 9V (n = 6).

Conclusions: CAP due to PCV13 serotypes is a source of morbidity among adults >50 years and may be reduced by greater access to pneumococcal vaccines.

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