The Burden of Pneumococcal Community-Acquired Pneumonia and Invasive Pneumococcal Disease in Hospitalized Adults: A Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS) Network Study
Notice bibliographique
Résumé
Background. Pneumococcal community acquired pneumonia (CAP) and invasive pneumococcal disease (IPD) cause significant morbidity and mortality worldwide. Although childhood immunization programs have reduced the burden of pneumococcal disease, there is insufficient data in Canada to advise immunization policy in adults. This study aimed to describe clinical outcomes of pneumococcal CAP and IPD in hospitalized Canadian adults, and determine the proportion of patients with vaccine-preventable disease. Methods. To establish the burden of pneumococcal disease, active surveillance for CAP and IPD in hospitalized adults was performed in five Canadian provinces from December 2010 to 2013. The serotype distribution was characterized using the Quellung reaction, PCR-based serotyping, and urine antigen detection (UAD). Results. Of 4769 cases of all-cause CAP, a laboratory test for pneumococci was performed in 3703. Of these, 516 (13.9%) were pneumococcal CAP (CAPSpn) and 238 (6.4%) were bacteremic CAPSpn. In addition to CAP, 80 cases of IPD (non-CAP) were identified. The burden of CAPSpn, bacteremic CAPSpn, and IPD was evident in terms of intensive care unit admission, mechanical ventilation, and 30-day mortality. Overall, the proportion of all-cause CAP with laboratory testing identifying a 13-valent pneumococcal conjugate vaccine (PCV13) or 23-valent pneumococcal polysaccharide vaccine (PPV23) serotype was 6.2% and 7.1%, respectively. However, these values are underestimated; 41.9% of the CAPSpn case isolates were not viable upon re-culturing, non-typeable, or unavailable for serotyping. Of the available serotypes, PCV13- and PPV23-serotypes represented 76.0% and 87.7% in CAPSpn, respectively. If these proportions are extrapolated to the overall contribution of CAPSpn to all-cause CAP of 13.9%, PCV13- and PPV23-serotypes would represent 10.6% and 12.2% of all-cause CAP, respectively. The results of a PCV13-specific UAD were consistent with this estimation at 197/1907 (10.3%). Conclusion. This study demonstrated that pneumococcal CAP and IPD are significant causes of morbidity and mortality in hospitalized Canadian adults, with a large proportion of available S. pneumoniae serotypes being vaccine-preventable. Disclosures. M. K. Andrew, GSK: Investigator, Research support; G. Boivin, Biocryst: Investigator, Research grant. Merck: Investigator, Research grant; W. Bowie, GSK: Investigato, Research grant; T. Hatchette, GSK: Investigator, Research grant; M. Loeb, GSK: Investigator, Research support; A. E. McCarthy, GSK: Investigator, Research support; S. A. McNeil, GSK: Grant Investigator, Research grant and Research support. Pfizer: Grant Investigator, Consulting fee, Research grant, Research support and Speaker honorarium. Merck: Consultant and Investigator, Consulting fee, Research support and Speaker honorarium
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».