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Adult invasive pneumococcal disease in the Republic of Korea: Risk medical conditions and mortality stratified by age group

Authors
Kim, Jong HunBaik, Seung HeeChun, Byung ChulSong, Joon YoungBae, In-GyuKim, Hyo YoulKim, Dong-MinChoi, Young HwaChoi, Won SukJo, Yu MiKwon, Hyun HeeJeong, Hye WonKim, Yeon-SookKim, Jeong YeonLee, JacobKee, Sae YoonHur, JianChung, Jin WonHwang, Ki-EunKim, Min Ja
Issue Date
9월-2018
Publisher
ELSEVIER SCI LTD
Keywords
Invasive pneumococcal disease; Adult; Risk factors; Mortality
Citation
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, v.74, pp.136 - 144
Indexed
SCIE
SCOPUS
Journal Title
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
Volume
74
Start Page
136
End Page
144
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/73264
DOI
10.1016/j.ijid.2018.07.018
ISSN
1201-9712
Abstract
Objectives: This study aimed to characterize the risk factors for mortality in adult patients with invasive pneumococcal disease (IPD) stratified by age groups, after implementation of the national immunization program of 23-valent polysaccharide vaccine (PPSV23) for those aged >= 65 years in the Republic of Korea (ROK). Methods: Clinical data and pneumococcal isolates from adult patients with IPD (>= 18 years of age) were collected prospectively from 20 hospitals through the nationwide surveillance program from March 2013 to October 2015. Results: A total of 319 patients with IPD were enrolled. Median age was 69 years. Overall in-hospital mortality was 34.2%: 17.1% in those aged 18-49 years, 23.7% in those aged 50-64 years, 33.0% in those aged 65-74 years, and 51.0% in those aged >= 75 years (p < 0.001). In particular, early death within 7 days of hospitalization accounted for 60.6% (66/109). While old age (>= 65 years), higher Pitt bacteremia score (>= 4), and bacteremic pneumonia were independently associated with IPD mortality in all age groups, an additional mortality risk factor of immunocompromised status was identified for patients aged 50-64 years. PPSV23 serotypes accounted for 64.4% (122/189) of the pneumococcal isolates serotyped. Conclusions: This study suggests that vaccine-type IPD continues to place a substantial burden on older adults in the ROK, necessitating an effective vaccination strategy for those at higher risk. (c) 2018 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
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