Epidemiology and clinical burden of invasive pneumococcal disease in older adults in the city of Sao Paulo, Brazil

Background: The Brazilian National Immunization Program does not offer universal pneumococcal vaccination for older adults. We evaluated the incidence, demographics, clinical characteristics, and outcomes of older adults with IPD in Sao Paulo, Brazil. Methods: A retrospective chart review of 94 adults aged 60+ hospitalized with IPD from 2016 to 2018 was conducted. Descriptive statistics summarized demographic and clinical data. Incidence was calculated by dividing the number of IPD patients in Sao Paulo by the population of individuals aged 60+ using the study hospitals. Results: Most patients had at least one risk factor, with cancer being the most common. Ninety percent had unknown vaccination status. The incidence rate per 100,000 people declined over the study period. Communityonset disease and bacteremic pneumonia were prevalent, while meningitis occurred in a smaller percentage. Hospitalization lasted a median of ten days, with 53 % of patients requiring ICU admission. Complications, supplemental oxygen, mechanical ventilation, and septic shock were observed during hospitalization. The case fatality rate for IPD was 43 %. Conclusion: The study highlights the significant burden of IPD in older adults in Sao Paulo and emphasizes the importance of extending pneumococcal vaccination to this population in Brazil to address the associated morbidity, mortality, and healthcare burden.