Navarro-Torné Adoración, Dias Joana Gomes, Hruba Frantiska, Lopalco Pier Luigi, Pastore-Celentano Lucia, Gauci Andrew J Amato
Emerg Infect Dis. 2015 Mar;21(3):417-25. doi: 10.3201/eid2103.140634.
We studied the possible association between patient age and sex, clinical presentation, Streptococcus pneumoniae serotype, antimicrobial resistance, and death in invasive pneumococcal disease cases reported by 17 European countries during 2010. The study sample comprised 2,921 patients, of whom 56.8% were men and 38.2% were >65 years of age. Meningitis occurred in 18.5% of cases. Death was reported in 264 (9.0%) cases. Older age, meningitis, and nonsusceptibility to penicillin were significantly associated with death. Non-pneumococcal conjugate vaccine (PCV) serotypes among children <5 years of age and 7-valent PCV serotypes among persons 5-64 years of age were associated with increased risk for death; among adults >65 years of age, risk did not differ by serotype. These findings highlight differences in case-fatality rates between serotypes and age; thus, continued epidemiologic surveillance across all ages is crucial to monitor the long-term effects of PCVs.
我们研究了2010年期间17个欧洲国家报告的侵袭性肺炎球菌病病例中患者年龄与性别、临床表现、肺炎链球菌血清型、抗菌药物耐药性及死亡之间的可能关联。研究样本包括2921名患者，其中56.8%为男性，38.2%年龄大于65岁。18.5%的病例发生了脑膜炎。264例（9.0%）报告死亡。年龄较大、患脑膜炎以及对青霉素不敏感与死亡显著相关。5岁以下儿童中的非肺炎球菌结合疫苗（PCV）血清型以及5 - 64岁人群中的7价PCV血清型与死亡风险增加相关；在65岁以上成年人中，死亡风险因血清型而异。这些发现凸显了不同血清型和年龄之间病死率的差异；因此，持续对所有年龄段进行流行病学监测对于监测PCV的长期影响至关重要。
