A retrospective analysis of hospital discharge records for S. pneumoniae diseases in the elderly population of Florence, Italy, 2010-2012 Implications for immunization policies

被引：6

作者：

Bechini, Angela ^{[1
]}

Taddei, Cristina ^{[1
]}

Barchielli, Alessandro ^{[2
]}

Levi, Miriam ^{[1
]}

Tiscione, Emilia ^{[1
]}

Santini, Maria Grazia ^{[3
]}

Niccolini, Fabrizio ^{[4
]}

Mechi, Maria Teresa ^{[4
]}

Panatto, Donatella ^{[5
]}

Amicizia, Daniela ^{[5
]}

Azzari, Chiara ^{[1
]}

Bonanni, Paolo ^{[1
]}

Boccalini, Sara ^{[1
]}

机构：

[1] Univ Florence, Dept Hlth Sci, Florence, Italy

[2] Local Hlth Unit Florence, Epidemiol Unit, Florence, Italy

[3] Local Hlth Unit Florence, Dept Prevent, Florence, Italy

[4] Careggi Univ Hosp, Hlth Direct, Florence, Italy

[5] Dept Hlth Sci, Genoa, Italy

来源：

HUMAN VACCINES & IMMUNOTHERAPEUTICS | 2015年 / 11卷 / 01期

关键词：

Streptococcus pneumoniae; hospitalizations; elderly; immunization policies; Pneumococcal conjugate vaccine; Tuscany; Italy; INVASIVE PNEUMOCOCCAL DISEASE; COMMUNITY-ACQUIRED PNEUMONIA; POLYSACCHARIDE CONJUGATE VACCINE; SEROTYPE DISTRIBUTION; CHILDREN; INFECTIONS; EXPERIENCE; BURDEN; IMPACT; ADULTS;

D O I：

10.4161/hv.34418

中图分类号：

Q81 [生物工程学（生物技术）]; Q93 [微生物学];

学科分类号：

071005 ; 0836 ; 090102 ; 100705 ;

摘要：

Invasive pneumococcal diseases (IPD) and community acquired pneumonia (CAP) represent two of the major causes of out-patient visits, hospital admissions and deaths in the elderly. In Tuscany (Italy), in the Local Health Unit of Florence, a project aimed at implementing an active surveillance of pneumococcal diseases in the hospitalized elderly population started in 2013. The aim of this study is to show the results of the retrospective analysis (2010-2012) on hospital discharge records (HDRs) related to diseases potentially due to S. pneumoniae, using a selection of ICD9-CM codes. All ordinary hospitalizations (primary and secondary diagnoses) of the elderly population were included (11245 HDRs). Among a population of about 200000 inhabitants 65 y, the hospitalization rate (HR) increased with increasing age and was higher in males in all age groups. Almost all hospitalizations (95%) were due to CAP, only 5% were invasive diseases. Only few cases of CAP were specified as related to S. pneumoniae, the percentage was higher in case of meningitis (100%) or septicemia (22%). In-hospital deaths over the three-year period were 1703 (case fatality rate: 15%). The risk of dying, being hospitalized for a disease potentially attributable to pneumococcus (as primary diagnosis) increased significantly with age (P < 0.001), the odds ratio (OR) per increasing age year was 1.06 (95% CI 1.05-1.07) and was higher in patients with co-existing medical conditions with respect to patients without comorbidities. Currently, an active surveillance system on S. pneumoniae diseases with the inclusion of bio-molecular tests (RT-PCR), is a key step to assess the effectiveness of the PCV13 vaccine (13-valent pneumococcal conjugate vaccine) in the elderly population after implementation of vaccination policies. The results of this study will provide the comparator baseline data for the evaluation of a possible immunization programme involving one or more cohorts of the elderly in Tuscany.

引用

页码：156 / 165

页数：10

共 31 条

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