TY - JOUR
T1 - Multiple comorbidities increase the risk of death from invasive pneumococcal disease under the age of 65 years
AU - The Invasive Pneumococcal Diseases Surveillance Study Group
AU - Hanada, Shigeo
AU - Takata, Misako
AU - Morozumi, Miyuki
AU - Iwata, Satoshi
AU - Fujishima, Seitaro
AU - Ubukata, Kimiko
N1 - Funding Information:
Our study was funded, in part, by a grant under the category ‘‘Research on Emerging and Re-emerging Infectious Diseases’’ (H22-013) from the Japanese Ministry of Health, Labour and Welfare (to K. Ubukata).
Funding Information:
Our study was funded, in part, by a grant under the category ‘‘Research on Emerging and Re-emerging Infectious Diseases’’ (H22-013) from the Japanese Ministry of Health, Labour and Welfare (to K. Ubukata).KU has received payment for lectures from Meiji Seika Pharma Co., Ltd., Pfizer Japan Inc., and HORIBA, Ltd. SI has received grant support from Sumitomo Dainippon Pharma Co., Ltd., Pfizer Japan Inc., Taisho Toyama Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Astellas Pharma Inc., and MSD K.K. SF has received grant support from Chugai Pharmaceuticals Co., Ltd., Tsumura & co., Otsuka Pharmaceutical Co., Ltd., Pfizer Inc., Astellas Pharma Inc., Shionogi Co, Ltd., Teijin Pharma, Ltd. The other authors declare that they have no conflict of interest.
Publisher Copyright:
© 2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
PY - 2021/9
Y1 - 2021/9
N2 - Introduction: Risk factors for death from invasive pneumococcal disease (IPD) have not been clearly established in patients aged under 65 years. We aimed to evaluate contributions of host and bacterial factors to the risk of death from IPD in patients aged under 65 years in Japan. Methods: In this prospective, observational, multicenter cohort study, patients with IPD (n = 581) aged 6–64 years were enrolled between 2010 and 2017. We investigated the role of host and bacterial factors in 28-day mortality. Results: The mortality rate increased from 3.4% to 6.2% in patients aged 6–44 years to 15.5%–19.5% in those aged 45–64 years. Multivariable analysis identified the following risk factors for mortality: age 45–64 years (hazard ratio [HR], 3.4; 95% confidence interval [CI], 1.6–6.8, p = 0.001), bacteremia with unknown focus (HR, 2.0; 95% CI, 1.1–3.7, p = 0.024), meningitis (HR, 2.1; 95% CI, 1.1–4.0, p = 0.019), underlying multiple non-immunocompromising conditions (HR, 2.6; 95% CI, 1.1–7.4, p = 0.023), and immunocompromising conditions related to malignancy (HR, 2.4; 95% CI, 1.0–5.2, p = 0.039). Pneumococcal serotype was not associated with poor outcomes. Conclusions: Host factors, including age of 45–64 years and underlying multiple non-immunocompromising conditions, are important for the prognosis of IPD. Our results will contribute to the development of targeted pneumococcal vaccination strategies in Japan.
AB - Introduction: Risk factors for death from invasive pneumococcal disease (IPD) have not been clearly established in patients aged under 65 years. We aimed to evaluate contributions of host and bacterial factors to the risk of death from IPD in patients aged under 65 years in Japan. Methods: In this prospective, observational, multicenter cohort study, patients with IPD (n = 581) aged 6–64 years were enrolled between 2010 and 2017. We investigated the role of host and bacterial factors in 28-day mortality. Results: The mortality rate increased from 3.4% to 6.2% in patients aged 6–44 years to 15.5%–19.5% in those aged 45–64 years. Multivariable analysis identified the following risk factors for mortality: age 45–64 years (hazard ratio [HR], 3.4; 95% confidence interval [CI], 1.6–6.8, p = 0.001), bacteremia with unknown focus (HR, 2.0; 95% CI, 1.1–3.7, p = 0.024), meningitis (HR, 2.1; 95% CI, 1.1–4.0, p = 0.019), underlying multiple non-immunocompromising conditions (HR, 2.6; 95% CI, 1.1–7.4, p = 0.023), and immunocompromising conditions related to malignancy (HR, 2.4; 95% CI, 1.0–5.2, p = 0.039). Pneumococcal serotype was not associated with poor outcomes. Conclusions: Host factors, including age of 45–64 years and underlying multiple non-immunocompromising conditions, are important for the prognosis of IPD. Our results will contribute to the development of targeted pneumococcal vaccination strategies in Japan.
KW - Invasive pneumococcal disease
KW - Outcome
KW - Pneumococcal conjugate vaccine
KW - Risk factor
KW - Serotype
KW - Underlying disease
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U2 - 10.1016/j.jiac.2021.04.018
DO - 10.1016/j.jiac.2021.04.018
M3 - Article
C2 - 33962862
AN - SCOPUS:85105282234
VL - 27
SP - 1311
EP - 1318
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
SN - 1341-321X
IS - 9
ER -