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Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases 7/2006

01.07.2006 | Article

Effect of prior pneumococcal vaccination on clinical outcome of hospitalized adults with community-acquired pneumococcal pneumonia

verfasst von: A. Mykietiuk, J. Carratalà, A. Domínguez, A. Manzur, N. Fernández-Sabé, J. Dorca, F. Tubau, F. Manresa, F. Gudiol

Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases | Ausgabe 7/2006

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Abstract

The aim of this study was to evaluate the effect of prior pneumococcal vaccination on the clinical outcome of 554 consecutive hospitalized adults with community-acquired pneumococcal pneumonia from 1995 to 2004, 61 of whom had been vaccinated in the 5 years before admission. Outcome variables that were compared in vaccinated and unvaccinated adults included the occurrence of bacteremia, the time to resolution of pneumonia symptoms, the length of hospital stay, and mortality. Prior pneumococcal vaccination was associated with a lower risk of bacteremia (odds ratio 0.46, 95% CI 0.22–0.98). Compared with unvaccinated patients, vaccine recipients had better clinical outcomes, which included a faster resolution of pneumonia symptoms. The median length of hospital stay was shorter in vaccinated patients (8.0 vs. 9.0 days; p=0.032). Overall case-fatality rates did not differ significantly between groups (1.6% vs. 6.2%; p=0.233). In conclusion, prior pneumococcal vaccination appears to be associated with a lower risk of bacteremia, a faster time to resolution of symptoms, and a shorter hospital stay in adults with pneumococcal pneumonia. The findings presented here provide additional support to the current vaccine recommendations and should encourage healthcare providers to increase pneumococcal vaccine coverage among targeted adult populations.
Literatur
1.
Zurück zum Zitat Kyaw MH, Rose CE Jr, Fry AM, Singleton JA, Moore Z, Zell ER, Whitney CG (2005) The influence of chronic illnesses on the incidence of invasive pneumococcal disease in adults. J Infect Dis 192:377–386PubMedCrossRef Kyaw MH, Rose CE Jr, Fry AM, Singleton JA, Moore Z, Zell ER, Whitney CG (2005) The influence of chronic illnesses on the incidence of invasive pneumococcal disease in adults. J Infect Dis 192:377–386PubMedCrossRef
2.
Zurück zum Zitat Gutierrez F, Masia M, Rodriguez JC, Ayelo A, Soldan B, Cebrian L, Mirete C, Royo G, Hidalgo AM (2003) Evaluation of the immunochromatographic Binax NOW assay for detection of Streptococcus pneumoniae urinary antigen in a prospective study of community-acquired pneumonia in Spain. Clin Infect Dis 36:286–292PubMedCrossRef Gutierrez F, Masia M, Rodriguez JC, Ayelo A, Soldan B, Cebrian L, Mirete C, Royo G, Hidalgo AM (2003) Evaluation of the immunochromatographic Binax NOW assay for detection of Streptococcus pneumoniae urinary antigen in a prospective study of community-acquired pneumonia in Spain. Clin Infect Dis 36:286–292PubMedCrossRef
3.
Zurück zum Zitat Pachón J, Prados MD, Capote F, Cuello JA, Garnacho J, Verano A (1990) Severe community-acquired pneumonia. Etiology, prognosis, and treatment. Am Rev Respir Dis 142:369–373PubMed Pachón J, Prados MD, Capote F, Cuello JA, Garnacho J, Verano A (1990) Severe community-acquired pneumonia. Etiology, prognosis, and treatment. Am Rev Respir Dis 142:369–373PubMed
4.
Zurück zum Zitat Bartlett JG, Dowell SF, Mandell LA, File TM Jr, Musher DM, Fine MJ (2000) Practice guidelines for the management of community-acquired pneumonia in adults. Clin Infect Dis 31:347–382PubMedCrossRef Bartlett JG, Dowell SF, Mandell LA, File TM Jr, Musher DM, Fine MJ (2000) Practice guidelines for the management of community-acquired pneumonia in adults. Clin Infect Dis 31:347–382PubMedCrossRef
5.
Zurück zum Zitat Ramirez JA, Bordon J (2001) Early switch from intravenous to oral antibiotics in hospitalized patients with bacteremic community-acquired Streptococcus pneumoniae pneumonia. Arch Intern Med 161:848–850PubMedCrossRef Ramirez JA, Bordon J (2001) Early switch from intravenous to oral antibiotics in hospitalized patients with bacteremic community-acquired Streptococcus pneumoniae pneumonia. Arch Intern Med 161:848–850PubMedCrossRef
6.
Zurück zum Zitat Feikin DR, Schuchat A, Kolczak M, Barrett NL, Harrison LH, Lefkowitz L, McGeer A, Farley MM, Vugia DJ, Lexau C, Stefonek KR, Patterson JE, Jorgensen JH (2000) Mortality from invasive pneumococcal pneumonia in the era of antibiotic resistance, 1995–1997. Am J Public Health 90:223–229PubMedCrossRef Feikin DR, Schuchat A, Kolczak M, Barrett NL, Harrison LH, Lefkowitz L, McGeer A, Farley MM, Vugia DJ, Lexau C, Stefonek KR, Patterson JE, Jorgensen JH (2000) Mortality from invasive pneumococcal pneumonia in the era of antibiotic resistance, 1995–1997. Am J Public Health 90:223–229PubMedCrossRef
7.
Zurück zum Zitat Garau J (2002) Treatment of drug-resistant pneumococcal pneumonia. Lancet Infect Dis 2:404–415PubMedCrossRef Garau J (2002) Treatment of drug-resistant pneumococcal pneumonia. Lancet Infect Dis 2:404–415PubMedCrossRef
8.
Zurück zum Zitat Whitney CG, Schaffner W, Butler JC (2001) Rethinking recommendations for use of pneumococcal vaccines in adults. Clin Infect Dis 33:662–675PubMedCrossRef Whitney CG, Schaffner W, Butler JC (2001) Rethinking recommendations for use of pneumococcal vaccines in adults. Clin Infect Dis 33:662–675PubMedCrossRef
9.
Zurück zum Zitat Jackson LA, Neuzil KM, Yu O, Benson P, Barlow WE, Adams AL, Hanson CA, Mahoney LD, Shay DK, Thompson WW (2003) Effectiveness of pneumococcal polysaccharide vaccine in older adults. N Engl J Med 348:1747–1755PubMedCrossRef Jackson LA, Neuzil KM, Yu O, Benson P, Barlow WE, Adams AL, Hanson CA, Mahoney LD, Shay DK, Thompson WW (2003) Effectiveness of pneumococcal polysaccharide vaccine in older adults. N Engl J Med 348:1747–1755PubMedCrossRef
10.
Zurück zum Zitat Domínguez A, Salleras L, Fedson DS, Izquierdo C, Ruíz L, Ciruela P, Fenoll A, Casal J (2005) Effectiveness of pneumococcal vaccination for elderly people in Catalonia, Spain: a case-control study. Clin Infect Dis 40:1250–1257PubMedCrossRef Domínguez A, Salleras L, Fedson DS, Izquierdo C, Ruíz L, Ciruela P, Fenoll A, Casal J (2005) Effectiveness of pneumococcal vaccination for elderly people in Catalonia, Spain: a case-control study. Clin Infect Dis 40:1250–1257PubMedCrossRef
11.
Zurück zum Zitat Örtqvist A, Hedlund J, Burman LA, Elbel E, Hofer M, Leinonen M, Lindblad I, Sundelof B, Kalin M (1998) Randomised trial of 23-valent pneumococcal capsular polysaccharide vaccine in prevention of pneumonia in middle-aged and elderly people. Lancet 351:399–403PubMedCrossRef Örtqvist A, Hedlund J, Burman LA, Elbel E, Hofer M, Leinonen M, Lindblad I, Sundelof B, Kalin M (1998) Randomised trial of 23-valent pneumococcal capsular polysaccharide vaccine in prevention of pneumonia in middle-aged and elderly people. Lancet 351:399–403PubMedCrossRef
12.
Zurück zum Zitat Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE, Coley CM, Marrie TJ, Kapoor WN (1997) A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med 336:243–250PubMedCrossRef Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE, Coley CM, Marrie TJ, Kapoor WN (1997) A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med 336:243–250PubMedCrossRef
13.
Zurück zum Zitat National Committee for Clinical Laboratory Standards (2004) Performance standards for antimicrobial susceptibility testing. Fourteenth informational supplement. Document M100-S14. NCCLS, Wayne, Pennsylvania, USA National Committee for Clinical Laboratory Standards (2004) Performance standards for antimicrobial susceptibility testing. Fourteenth informational supplement. Document M100-S14. NCCLS, Wayne, Pennsylvania, USA
14.
Zurück zum Zitat Centers for Disease Control and Prevention (1997) Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 46 (RR-8):1–24 Centers for Disease Control and Prevention (1997) Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 46 (RR-8):1–24
15.
Zurück zum Zitat Ament A, Baltussen R, Duru G, Rigaud-Bully C, de Graeve D, Ortqvist A, Jonsson B, Verhaegen J, Gaillat J, Christie P, Cifre AS, Vivas D, Loiseau C, Fedson DS (2000) Cost-effectiveness of pneumococcal vaccination of older people: a study in 5 western European countries. Clin Infect Dis 31:444–450PubMedCrossRef Ament A, Baltussen R, Duru G, Rigaud-Bully C, de Graeve D, Ortqvist A, Jonsson B, Verhaegen J, Gaillat J, Christie P, Cifre AS, Vivas D, Loiseau C, Fedson DS (2000) Cost-effectiveness of pneumococcal vaccination of older people: a study in 5 western European countries. Clin Infect Dis 31:444–450PubMedCrossRef
16.
Zurück zum Zitat Greci LS, Katz DL, Jekel J (2005) Vaccinations in pneumonia: pneumococcal and influenza vaccination patterns among patients hospitalized for pneumonia. Prev Med 40:384–388PubMedCrossRef Greci LS, Katz DL, Jekel J (2005) Vaccinations in pneumonia: pneumococcal and influenza vaccination patterns among patients hospitalized for pneumonia. Prev Med 40:384–388PubMedCrossRef
17.
Zurück zum Zitat Musher DM, Alexandraki I, Graviss EA, Yanbeiy N, Eid A, Inderias L, Phan H, Solomon E (2000) Bacteremic and nonbacteremic pneumococcal pneumonia. A prospective study. Medicine (Baltimore) 79:210–221CrossRef Musher DM, Alexandraki I, Graviss EA, Yanbeiy N, Eid A, Inderias L, Phan H, Solomon E (2000) Bacteremic and nonbacteremic pneumococcal pneumonia. A prospective study. Medicine (Baltimore) 79:210–221CrossRef
18.
Zurück zum Zitat Centers for Disease Control and Prevention (1997) Missed opportunities for pneumococcal and influenza vaccination of Medicare pneumonia inpatients—12 western states, 1995. MMWR Morb Mortal Wkly Rep 46:919–923 Centers for Disease Control and Prevention (1997) Missed opportunities for pneumococcal and influenza vaccination of Medicare pneumonia inpatients—12 western states, 1995. MMWR Morb Mortal Wkly Rep 46:919–923
19.
Zurück zum Zitat Nichol KL, MacDonald R, Hauge M (1997) Side effects associated with pneumococcal vaccination. Am J Infect Control 25:223–228PubMedCrossRef Nichol KL, MacDonald R, Hauge M (1997) Side effects associated with pneumococcal vaccination. Am J Infect Control 25:223–228PubMedCrossRef
20.
Zurück zum Zitat Sisk JE, Whang W, Butler JC, Sneller VP, Whitney CG (2003) Cost-effectiveness of vaccination against invasive pneumococcal disease among people 50 through 64 years of age: role of comorbid conditions and race. Ann Intern Med 138:960–968PubMed Sisk JE, Whang W, Butler JC, Sneller VP, Whitney CG (2003) Cost-effectiveness of vaccination against invasive pneumococcal disease among people 50 through 64 years of age: role of comorbid conditions and race. Ann Intern Med 138:960–968PubMed
21.
Zurück zum Zitat Rhew DC, Tu GS, Ofman J, Henning JM, Richards MS, Weingarten SR (2001) Early switch and early discharge strategies in patients with community-acquired pneumonia. A meta-analysis. Arch Intern Med 161:722–727PubMedCrossRef Rhew DC, Tu GS, Ofman J, Henning JM, Richards MS, Weingarten SR (2001) Early switch and early discharge strategies in patients with community-acquired pneumonia. A meta-analysis. Arch Intern Med 161:722–727PubMedCrossRef
Metadaten
Titel
Effect of prior pneumococcal vaccination on clinical outcome of hospitalized adults with community-acquired pneumococcal pneumonia
verfasst von
A. Mykietiuk
J. Carratalà
A. Domínguez
A. Manzur
N. Fernández-Sabé
J. Dorca
F. Tubau
F. Manresa
F. Gudiol
Publikationsdatum
01.07.2006
Verlag
Springer-Verlag
Erschienen in
European Journal of Clinical Microbiology & Infectious Diseases / Ausgabe 7/2006
Print ISSN: 0934-9723
Elektronische ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-006-0161-8

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