Ahead of Print -Risk Factors for Death from Invasive Pneumococcal Disease, Europe, 2010 - Volume 21, Number 3—March 2015 - Emerging Infectious Disease journal - CDC
Volume 21, Number 3—March 2015
Risk Factors for Death from Invasive Pneumococcal Disease, Europe, 2010
Streptococcus pneumoniae causes severe invasive disease that results in considerable illness and death. The incidence of invasive pneumococcal disease (IPD) is higher during the early years of life and among elderly persons (1). Geographic and ethnic differences also exist (1,2). Environmental factors (i.e., ambient temperature, humidity, and air pollution) affect IPD incidence (3,4). IPD has also been related to recent respiratory viral infection (4).
The ability of the different S. pneumoniae serotypes to cause disease has been related to serotype-specific characteristics and the molecular size of the capsular polysaccharide and chemical composition, among other factors (5). Therefore, it seems plausible that different serotypes exhibit different virulence and propensity to cause certain clinical presentation (5).
Brueggemann et al. studied the invasive disease potential of different S. pneumoniae serotypes (6). They concluded that so-called “highly invasive” serotypes (including 4, 1, 14, 18C, and 7F), convey a higher risk for invasive disease than do the “low invasive” serotypes (including 3, 15B/C, and 6B), which are more frequently isolated as colonizers (7). Furthermore, serotype distribution varies with patient age, both in disease and in nasopharyngeal colonization (2,8–10). However, evidence exists that pneumococcal invasiveness does not necessarily mean lethality (7). Low invasive serotypes usually account for higher case-fatality rates (CFRs).
The availability of 7-valent, 10-valent, and 13-valent pneumococcal conjugate vaccines (PCV7, PCV10, and PCV13, respectively) and their introduction as part of national immunization schedules have contributed to reducing illnesses and death from IPD (10–12). Nevertheless, the subsequent replacement of vaccine serotypes by nonvaccine serotypes is an accepted and global phenomenon (13,14).
The incidence of drug- and multidrug-resistant S. pneumoniae strains is increasing worldwide (15). Antimicrobial use and abuse is a main driver for the emergence of antimicrobial resistance in respiratory pathogens. Persons who carry (nasopharyngeal colonization), and hence share the potential to transmit resistant pneumococci, also are more susceptible to IPD caused by resistant strains (16).
Monitoring antimicrobial resistance trends and serotype distribution is paramount because this information is essential in helping to determine risk factors and optimizing the appropriate clinical management of cases and public health interventions. We studied the possible association between age, sex, serotype, clinical presentation, antimicrobial resistance, and death among persons reported to have IPD in European countries during 2010.
Dr. Navarro-Torné is an expert in vaccine preventable diseases at the European Centre for Disease Prevention and Control. Her primary research interest is surveillance of vaccine preventable diseases, particularly on IPD and pertussis.
Members of the Invasive Pneumococcal Disease Study Group who contributed data this article: Martine Sabbe, Antoaneta Detcheva, Teodora Georgieva, Despo Pieridou Bagatzouni,Pavla Křížová, Palle Valentiner-Branth, Asunción Fenoll, Anni Virolainen-Julkunen,Theano Georgakopoulou, Georgina Tzanakaki, Márta Melles, Imelda Vickers, Suzanne Cotter, Hilary Humphreys, Karl G. Kristinsson, Maria Grazia Caporali, Fortunato Paolo D’Ancona, Stefania Iannazzo, Annalisa Pantosti, Jelena Galajeva, Paul Caruana, Jackie Maistre Melillo, Tanya Melillo Fenech, Hester De Melker, Mirjam Knol, Arie Van Der Ende, Martin Steinbakk, Didrik F Vestrheim,Waleria Hryniewicz, Alicja Kuch, Iwona Paradowska-Stankiewicz, Anna Skoczynska, Marina Pana, Birgitta Henriques-Normak, Alenka Kraigher, Maja Sočan, Helena Hupkova, Eisin MacDonald, Mary P.E. Slack, Pauline A. Waight.
- Lynch JP, Zhanel GG. Streptococcus pneumoniae: epidemiology and risk factors, evolution of antimicrobial resistance and impact of vaccines. Curr Opin Pulm Med. 2010;16:217–25 .PubMed
- Scott JA, Hall AJ, Dagan R, Dixon JMS, Eykyn SJ, Fenoll A, Serogroup-specific epidemiology of Streptococcus pneumoniae: associations with age, sex and geography in 7000 episodes of invasive disease. Clin Infect Dis. 1996;22:973–81. DOIPubMed
- Weinberger DM, Grant LR, Steiner CA, Weatherholtz R, Santosham M, Viboud C, Seasonal drivers of pneumococcal disease incidence: impact of bacterial carriage and viral activity. Clin Infect Dis. 2014;58:188–94. DOIPubMed
- Launes C, Fernandez de Sevilla M, Selva L, Garcia Garcia JJ, Pallares R, Muñoz-Almagro C. Viral co-infection in children less than five years old with invasive pneumococcal disease. Pediatr Infect Dis J. 2012;31:650–3. DOIPubMed
- Weinberger DM, Harboe ZB, Sanders EAM, Ndiritu M, Klugman KP, Rückinger S, Risk of death from pneumococcal pneumonia is a stable serotype-associated property: a meta-analysis. Clin Infect Dis. 2010;51:692–9. DOIPubMed
- Brueggemann AB, Griffiths DT, Meats E, Peto T, Crook DW, Spratt BG. Clonal relationships between invasive and carriage Streptococcus pneumoniae and serotype- and clone-specific differences in invasive disease potential. J Infect Dis. 2003;187:1424–32. DOIPubMed
- Pletz MW, Welte T, Klugman KP. The paradox in pneumococcal serotypes: highly invasive does not mean highly lethal. Eur Respir J. 2010;36:712–3.DOIPubMed
- Johnson HL, Deloria-Knoll M, Levine OS, Stoszek SK, Freimanis Hance L, Reithinger R, Systematic evaluation of serotypes causing invasive pneumococcal disease among children under five: the pneumococcal global serotype project. PLoS Med. 2010;7:e1000348. DOIPubMed
- Jansen AGSC, Rodenburg GD, van der Ende A, van Alphen L, Veenhoven RH, Spanjaard L, Invasive pneumococcal disease among adults: association among serotypes, disease characteristics, and outcome. Clin Infect Dis. 2009;49:e23–9. DOIPubMed
- Hausdorff WP, Feikin DR, Klugman KP. Epidemiological differences among pneumococcal serotypes. Lancet Infect Dis. 2005;5:83–93.DOIPubMed
- Miller E, Andrews NJ, Waight PA, Slack MP, George RC. Effectiveness of the new serotypes in the 13-valent pneumococcal conjugate vaccine.Vaccine. 2011;29:9127–31. DOIPubMed
- Palmu AA, Jokinen J, Nieminen H, Borys D, Nieminen H, Ruokokoski E, Effectiveness of the ten-valent pneumococcal Haemophilus influenzaeprotein D conjugate vaccine (PHiD-CV10) against invasive pneumococcal disease: a cluster randomized trial. Lancet. 2013;381:214–22.DOIPubMed
- Weinberger DM, Malley R, Lipsitch M. Serotype replacement in disease after pneumococcal vaccination. Lancet. 2011;378:1962–73.DOIPubMed
- Weil-Olivier C, van der Linden M, de Schutter I, Dagan R, Mantovani L. Prevention of pneumococcal diseases in the post-seven valent vaccine era: a European perspective. BMC Infect Dis. 2012;12:207. DOIPubMed
- Reinert RR. The antimicrobial resistance profile of Streptococcus pneumoniae. Clin Microbiol Infect. 2009;15(Suppl 3):7–11. DOIPubMed
- Dagan R, Barkai G, Leibovitz E, Dreifuss E, Greenerg D. Will reduction of antibiotic use reduce antibiotic resistance? The pneumococcus paradigm.Pediatr Infect Dis J. 2006;25:981–6. DOIPubMed
- European Antimicrobial Resistance Surveillance Network (EARS-Net). Antimicrobial resistance interactive database (EARS-Net) [cited 2014 Mar 2].http://www.ecdc.europa.eu/en/healthtopics/antimicrobial_resistance/database/Pages/database.aspx
- European Centre for Disease Prevention and Control. Surveillance of invasive pneumococcal disease in Europe, 2010 [cited 2014 Mar 3].http://www.ecdc.europa.eu/en/publications/publications/invasive-pneumoccocal-disease-surveillance-2010.pdf
- Luján M, Gallego M, Belmont Y, Fontanals D, Vallés J, Lisboa T, Influence of pneumococcal serotype group on outcome in adults with bacteraemic pneumonia. Eur Respir J. 2010;36:1073–9. DOIPubMed
- Martens P, Worm SW, Lundgren B, Konradsen HB, Benfield T. Serotype-specific mortality from invasive Streptococcus pneumoniae disease revisited. BMC Infect Dis. 2004;4:21. DOIPubMed
- Yu VL, Chiou CCC, Feldman C, Ortqvist A, Rello J, Morris AJ, An international prospective study of pneumococcal bacteremia: correlation with in vitro resistance, antibiotics administered, and clinical outcome. Clin Infect Dis. 2003;37:230–7. DOIPubMed
- Regev-Yochay G, Rahav G, Riesenberg K, Wiener-Well Y, Strahilevitz J, Stein M, Initial effects of the national PCV7 childhood immunization program on adult invasive pneumococcal disease. PLoS ONE. 2014;9:e88406. DOIPubMed
- Simell B, Lahdenkari M, Reunanen A, Käyhty H, Väkeväinen M. Effects of ageing and gender on naturally acquired antibodies to pneumococcal capsular polysaccharides and virulence-associated proteins. Clin Vaccine Immunol. 2008;15:1391–7. DOIPubMed
- European Centre for Disease Prevention and Control. Vaccine schedule. Recommended immunisations for pneumococcal disease [cited 2014 Apr 7].http://vaccine-schedule.ecdc.europa.eu/Pages/Scheduler.aspx
- Harboe ZB, Thomsen RW, Riis A, Valentiner-Branth P, Christensen JJ, Lambertsen L, Pneumococcal serotypes and mortality following invasive pneumococcal disease: a population-based cohort study. PLoS Med. 2009;6:e1000081. DOIPubMed
- Vallès X, Marcos A, Pinart M, Piñer R, Marco F, Mensa JM, Hospitalized community-acquired pneumonia due to Streptococcus pneumoniae. Has resistance to antibiotics decreased? Chest. 2006;130:800–6. DOIPubMed
- Roed C, Engsig FN, Omland LH, Skinhoj P, Obel N. Long-term mortality in patients diagnosed with pneumococcal meningitis: a Danish nationwide cohort. Am J Epidemiol. 2010;172:309–17. DOIPubMed
- Rückinger S, von Kries R, Siedler A, van der Linden M. Association of serotype of Streptococcus pneumoniae with risk of severe and fatal outcome.Pediatr Infect Dis J. 2009;28:118–22. DOIPubMed
- Ladhani SN, Slack MPE, Andrews NJ, Waight PA, Borrow R, Miller E. Invasive pneumococcal disease after routine pneumococcal conjugate vaccination in children, England and Wales. Emerg Infect Dis. 2013;19:61–8. DOIPubMed
- Pichon B, Ladhani SN, Slack MPE, Segonds-Pichon A, Andrews NJ, Waight PA, Changes in molecular epidemiology of Streptococcus pneumoniaecausing meningitis following introduction of pneumococcal conjugate vaccination in England and Wales. J Clin Microbiol. 2013;51:820–7.DOIPubMed
- Li Y, Weinberger DM, Thompson CM, Trzciński K, Lipsitch M. Surface charge of Streptococcus pneumoniae predicts serotype distribution. Infect Immun. 2013;81:4519–24. DOIPubMed
- van Hoek AJ, Andrews N, Waight PA, George R, Miller E. Effect of serotype on focus and mortality of invasive pneumococcal disease: coverage of different vaccines and insight into non-vaccine serotypes. PLoS ONE. 2012;7:e39150. DOIPubMed
- Myint TTH, Madhava H, Balmer P, Christopoulou D, Attal S, Menegas D, The impact of 7-valent pneumococcal conjugate vaccine on invasive pneumococcal disease: a literature review. Adv Ther. 2013;30:127–51. DOIPubMed
- Sjöström K, Spindler C, Örtqvist A, Kalin M, Sandgren A, Kühlmann-Berenzon S, Clonal and capsular types decide whether pneumococci will act as a primary or opportunistic pathogen. Clin Infect Dis. 2006;42:451–9. DOIPubMed
- Fenoll A, Aguilar L, Giménez MJ, Vicioso MD, Robledo O, Granizo JJ, Susceptibility of recently collected Spanish pneumococci nonsusceptible to oral penicillin from serotypes not included in the 7-valent conjugate vaccine. Antimicrob Agents Chemother. 2010;54:2696–8. DOIPubMed
- Gouveia EL, Reis JN, Flannery B, Cordeiro SM, Lima JBT, Pinheiro RM, Clinical outcome of pneumococcal meningitis during the emergence of penicillin-resistant Streptococcus pneumoniae: an observational study. BMC Infect Dis. 2011;11:323. DOIPubMed
- Song JS, Choe PG, Song KH, Park WB, Park SW, Kim HB, Risk factors for 30-day mortality in adult patients with pneumococcal bacteraemia, and the impact of antimicrobial resistance on clinical outcomes. Epidemiol Infect. 2012;140:1267–76. DOIPubMed
- Feldman C, Anderson RA. Bacteremic pneumococcal pneumonia: current therapeutic options. Drugs. 2011;71:131–53. DOIPubMed
- Vila-Corcoles A, Ochoa-Gondar O. Preventing pneumococcal disease in the elderly. Recent advances in vaccines and implications for clinical practice. Drugs Aging. 2013;30:263–76. DOIPubMed
- Miyaji EN, Sarno Oliveira ML, Carvalho E, Lee Ho P. Serotype-independent pneumococcal vaccines. Cell Mol Life Sci. 2013;70:3303–26 and.DOIPubMed
Suggested citation for this article: Navarro-Torné A, Gomes Dias J, Hruba F, Lopalco PL, Pastore-Celentano L, Amato Gauci AJ, et al. Risk factors for death from invasive pneumococcal disease, Europe, 2010. Emerg Infect Dis [Internet]. 2015 Mar [date cited]. http://dx.doi.org/10.3201/eid2103.140634
No hay comentarios:
Publicar un comentario