Invasive pneumococcal disease in adults after the introduction of pneumococcal vaccination: a retrospective study in the metropolitan area of Zagreb, Croatia (2010-2022)

作者：Čivljak R, Draženović K, Butić I, Kljaković Gašpić Batinjan M, Huljev E, Vicković N, Lizatović IK, Grgić B, Budimir A, Janeš A, Nikić Hecer A, Filipec Kanižaj T, Tešić V, Kosanović Ličina ML, Dobrović K · 发表于：Frontiers in public health · 年份：2024 · DOI：10.3389/fpubh.2024.1480348 · 研究领域：adults、incidence、invasive pneumococcal disease、meningitis、mortality、pneumonia、primary bacteremia、vaccination

INTRODUCTION: Invasive pneumococcal disease (IPD) is a severe form of illness caused by Streptococcus pneumoniae with high morbidity and mortality rate in the general population, particularly in children <5 years of age, adults ≥65 years of age and the immunocompromised. As known, pneumococcal vaccination lowers the risk of IPD so the aim of this study was to investigate whether the introduction of pneumococcal vaccination has influenced the incidence and mortality of IPD in adults in Croatia. MATERIALS AND METHODS: A retrospective study was conducted among adult patients (aged ≥18 years) hospitalized due to IPD in the metropolitan area of Zagreb from 1st January 2010 to 31st December 2022. Number of vaccine doses distributed were obtained from the healthcare system. RESULTS: During the study period, 389 patients were hospitalized, of whom 214 (55.5%) were male. The annual incidence of IPD ranged from 0.6 to 4.1/100,000 population. A total of 185 (47.6%) patients were ≥ 65 years of age and 309 (79.4%) were ≥ 50 years of age. In 331 (85.1%) of the patients, at least one risk factor was identified, with age ≥ 65 years being the most common. Bacteremic pneumonia was the most frequent clinical presentation of IPD (66.3%). Indication for vaccination had 249 patients (64%) but only 11 patients (4.4%) were vaccinated. Also, 64 patients (16.5%) died. Serotype was determined in 233 (59.9%) of the isolates, with serotype 3 being the most frequent (49, 21%), followed by serotype 14 (3...