Effectiveness of 23-valent pneumococcal polysaccharide vaccination in preventing community-acquired pneumonia hospitalization and severe outcomes in the elderly in Spain
Pneumococcal pneumonia is a serious cause of morbidity and mortality in the elderly, but investigation of the etiological agent of community-acquired pneumonia (CAP) is not possible in most hospitalized patients. The aim of this study was to estimate the effect of pneumococcal polysaccharide vaccina...
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| Veröffentlicht in: | PloS one 2017-02, Vol.12 (2), p.e0171943 |
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| creator | Domínguez, Àngela Soldevila, Núria Toledo, Diana Torner, Núria Force, Luis Pérez, María José Martín, Vicente Rodríguez-Rojas, Lourdes Astray, Jenaro Egurrola, Mikel Sanz, Francisco Castilla, Jesús |
| description | Pneumococcal pneumonia is a serious cause of morbidity and mortality in the elderly, but investigation of the etiological agent of community-acquired pneumonia (CAP) is not possible in most hospitalized patients. The aim of this study was to estimate the effect of pneumococcal polysaccharide vaccination (PPSV23) in preventing CAP hospitalization and reducing the risk of intensive care unit admission (ICU) and fatal outcomes in hospitalized people aged ≥65 years. We made a multicenter case-control study in 20 Spanish hospitals during 2013-2014 and 2014-2015. We selected patients aged ≥65 years hospitalized with a diagnosis of pneumonia and controls matched by sex, age and date of hospitalization. Multivariate analysis was performed using conditional logistic regression to estimate vaccine effectiveness and unconditional logistic regression to evaluate the reduction in the risk of severe and fatal outcomes. 1895 cases and 1895 controls were included; 13.7% of cases and 14.4% of controls had received PPSV23 in the last five years. The effectiveness of PPSV23 in preventing CAP hospitalization was 15.2% (95% CI -3.1-30.3). The benefit of PPSV23 in avoiding ICU admission or death was 28.1% (95% CI -14.3-56.9) in all patients, 30.9% (95% CI -32.2-67.4) in immunocompetent patients and 26.9% (95% CI -38.6-64.8) in immunocompromised patients. In conclusion, PPSV23 showed a modest trend to avoidance of hospitalizations due to CAP and to the prevention of death or ICU admission in elderly patients hospitalized with a diagnosis of CAP. |
| doi_str_mv | 10.1371/journal.pone.0171943 |
| format | Article |
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The aim of this study was to estimate the effect of pneumococcal polysaccharide vaccination (PPSV23) in preventing CAP hospitalization and reducing the risk of intensive care unit admission (ICU) and fatal outcomes in hospitalized people aged ≥65 years. We made a multicenter case-control study in 20 Spanish hospitals during 2013-2014 and 2014-2015. We selected patients aged ≥65 years hospitalized with a diagnosis of pneumonia and controls matched by sex, age and date of hospitalization. Multivariate analysis was performed using conditional logistic regression to estimate vaccine effectiveness and unconditional logistic regression to evaluate the reduction in the risk of severe and fatal outcomes. 1895 cases and 1895 controls were included; 13.7% of cases and 14.4% of controls had received PPSV23 in the last five years. The effectiveness of PPSV23 in preventing CAP hospitalization was 15.2% (95% CI -3.1-30.3). The benefit of PPSV23 in avoiding ICU admission or death was 28.1% (95% CI -14.3-56.9) in all patients, 30.9% (95% CI -32.2-67.4) in immunocompetent patients and 26.9% (95% CI -38.6-64.8) in immunocompromised patients. In conclusion, PPSV23 showed a modest trend to avoidance of hospitalizations due to CAP and to the prevention of death or ICU admission in elderly patients hospitalized with a diagnosis of CAP.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0171943</identifier><identifier>PMID: 28187206</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Aged, 80 and over ; Analysis ; Biology and Life Sciences ; Care and treatment ; Case-Control Studies ; Communities ; Community-Acquired Infections - epidemiology ; Community-Acquired Infections - prevention & control ; Community-Acquired Infections - therapy ; Diagnosis ; Disease prevention ; Etiology ; Female ; Geriatrics ; Hospitalization ; Hospitalization - statistics & numerical data ; Humans ; Immunization ; Immunocompromised hosts ; Male ; Medicine and Health Sciences ; Morbidity ; Mortality ; Multivariate analysis ; Older people ; Patients ; People and Places ; Persones grans ; Pneumococcal pneumonia ; Pneumococcal Vaccines - therapeutic use ; Pneumonia ; Pneumonia, Pneumococcal - epidemiology ; Pneumonia, Pneumococcal - prevention & control ; Pneumonia, Pneumococcal - therapy ; Pneumònia ; Polisacàrids ; Polysaccharides ; Prevention ; Regression analysis ; Risk reduction ; Spain ; Streptococcus infections ; Streptococcus pneumoniae ; Treatment outcome ; Vaccination ; Vaccination - statistics & numerical data ; Vaccine efficacy ; Vaccines ; Vacunes</subject><ispartof>PloS one, 2017-02, Vol.12 (2), p.e0171943</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Domínguez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>cc-by (c) Domínguez García, Àngela et al., 2017 info:eu-repo/semantics/openAccess <a href="http://creativecommons.org/licenses/by/3.0/es">http://creativecommons.org/licenses/by/3.0/es</a></rights><rights>2017 Domínguez et al 2017 Domínguez et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c701t-d9d6a3dfaec5651f40a30982f5470bd140f4bb49fe9331c6fefa5a421a3c8fb03</citedby><cites>FETCH-LOGICAL-c701t-d9d6a3dfaec5651f40a30982f5470bd140f4bb49fe9331c6fefa5a421a3c8fb03</cites><orcidid>0000-0003-0219-1907</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5302444/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5302444/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,26951,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28187206$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Borrow, Ray</contributor><creatorcontrib>Domínguez, Àngela</creatorcontrib><creatorcontrib>Soldevila, Núria</creatorcontrib><creatorcontrib>Toledo, Diana</creatorcontrib><creatorcontrib>Torner, Núria</creatorcontrib><creatorcontrib>Force, Luis</creatorcontrib><creatorcontrib>Pérez, María José</creatorcontrib><creatorcontrib>Martín, Vicente</creatorcontrib><creatorcontrib>Rodríguez-Rojas, Lourdes</creatorcontrib><creatorcontrib>Astray, Jenaro</creatorcontrib><creatorcontrib>Egurrola, Mikel</creatorcontrib><creatorcontrib>Sanz, Francisco</creatorcontrib><creatorcontrib>Castilla, Jesús</creatorcontrib><creatorcontrib>Working Group of the Project PI12/02079</creatorcontrib><title>Effectiveness of 23-valent pneumococcal polysaccharide vaccination in preventing community-acquired pneumonia hospitalization and severe outcomes in the elderly in Spain</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Pneumococcal pneumonia is a serious cause of morbidity and mortality in the elderly, but investigation of the etiological agent of community-acquired pneumonia (CAP) is not possible in most hospitalized patients. The aim of this study was to estimate the effect of pneumococcal polysaccharide vaccination (PPSV23) in preventing CAP hospitalization and reducing the risk of intensive care unit admission (ICU) and fatal outcomes in hospitalized people aged ≥65 years. We made a multicenter case-control study in 20 Spanish hospitals during 2013-2014 and 2014-2015. We selected patients aged ≥65 years hospitalized with a diagnosis of pneumonia and controls matched by sex, age and date of hospitalization. Multivariate analysis was performed using conditional logistic regression to estimate vaccine effectiveness and unconditional logistic regression to evaluate the reduction in the risk of severe and fatal outcomes. 1895 cases and 1895 controls were included; 13.7% of cases and 14.4% of controls had received PPSV23 in the last five years. The effectiveness of PPSV23 in preventing CAP hospitalization was 15.2% (95% CI -3.1-30.3). 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In conclusion, PPSV23 showed a modest trend to avoidance of hospitalizations due to CAP and to the prevention of death or ICU admission in elderly patients hospitalized with a diagnosis of CAP.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Case-Control Studies</subject><subject>Communities</subject><subject>Community-Acquired Infections - epidemiology</subject><subject>Community-Acquired Infections - prevention & control</subject><subject>Community-Acquired Infections - therapy</subject><subject>Diagnosis</subject><subject>Disease prevention</subject><subject>Etiology</subject><subject>Female</subject><subject>Geriatrics</subject><subject>Hospitalization</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Immunization</subject><subject>Immunocompromised hosts</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Older people</subject><subject>Patients</subject><subject>People and Places</subject><subject>Persones grans</subject><subject>Pneumococcal pneumonia</subject><subject>Pneumococcal Vaccines - therapeutic use</subject><subject>Pneumonia</subject><subject>Pneumonia, Pneumococcal - epidemiology</subject><subject>Pneumonia, Pneumococcal - prevention & control</subject><subject>Pneumonia, Pneumococcal - therapy</subject><subject>Pneumònia</subject><subject>Polisacàrids</subject><subject>Polysaccharides</subject><subject>Prevention</subject><subject>Regression analysis</subject><subject>Risk reduction</subject><subject>Spain</subject><subject>Streptococcus infections</subject><subject>Streptococcus pneumoniae</subject><subject>Treatment outcome</subject><subject>Vaccination</subject><subject>Vaccination - statistics & numerical data</subject><subject>Vaccine efficacy</subject><subject>Vaccines</subject><subject>Vacunes</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>XX2</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11rFDEUhgdRbF39B6IDguDFrvmar5tCKVULhYJVb8PZzMluykwyTTKL6z_yX5rtTksXFGQIk2Se983MO-dk2WtKFpRX9OONG72FbjE4iwtCK9oI_iQ7pg1n85IR_vTR_Ch7EcINIQWvy_J5dsRqWleMlMfZ73OtUUWzQYsh5E7njM830KGN-WBx7J1ySkGXD67bBlBqDd60mG_S1FiIxtnc2HzwmByisatcub4frYnbOajb0XhsJyNrIF-7MJgInfm1l4Jt85CkHnM3xiTFsLOLa8yxa9F3293yegBjX2bPNHQBX033Wfb90_m3sy_zy6vPF2enl3NVERrnbdOWwFsNqIqyoFoQ4KSpmS5ERZYtFUSL5VI0GhvOqSo1aihAMApc1XpJ-Cx7u_cdOhfklHKQtC4rWpCGV4m42BOtgxs5eNOD30oHRt5tOL-S4KNRHUrKNGuogiXXIKAqa1YwVhWUgah5y1TyOplOG5c9tiqF6KE7MD18Ys1artxGFpwwIUQyoHsDFUYlPSr0CuKd8GGxG4xUTHJSFiVPmnfTod7djhjiPz5zolapHKSx2qUXUL0JSp6KmpQlqxI3yxZ_odLVYm9Uqk1t0v6B4MOBIDERf8YVjCHIi-uv_89e_Thk3z9i1whdXAfXjbs6C4egmBLzLgSP-iFtSuSute7TkLvWklNrJdmbx3_qQXTfS_wPBkgjVA</recordid><startdate>20170210</startdate><enddate>20170210</enddate><creator>Domínguez, Àngela</creator><creator>Soldevila, Núria</creator><creator>Toledo, Diana</creator><creator>Torner, Núria</creator><creator>Force, Luis</creator><creator>Pérez, María José</creator><creator>Martín, Vicente</creator><creator>Rodríguez-Rojas, Lourdes</creator><creator>Astray, Jenaro</creator><creator>Egurrola, Mikel</creator><creator>Sanz, Francisco</creator><creator>Castilla, Jesús</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>XX2</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-0219-1907</orcidid></search><sort><creationdate>20170210</creationdate><title>Effectiveness of 23-valent pneumococcal polysaccharide vaccination in preventing community-acquired pneumonia hospitalization and severe outcomes in the elderly in Spain</title><author>Domínguez, Àngela ; Soldevila, Núria ; Toledo, Diana ; Torner, Núria ; Force, Luis ; Pérez, María José ; Martín, Vicente ; Rodríguez-Rojas, Lourdes ; Astray, Jenaro ; Egurrola, Mikel ; Sanz, Francisco ; Castilla, Jesús</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c701t-d9d6a3dfaec5651f40a30982f5470bd140f4bb49fe9331c6fefa5a421a3c8fb03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Case-Control Studies</topic><topic>Communities</topic><topic>Community-Acquired Infections - 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Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>Recercat</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Domínguez, Àngela</au><au>Soldevila, Núria</au><au>Toledo, Diana</au><au>Torner, Núria</au><au>Force, Luis</au><au>Pérez, María José</au><au>Martín, Vicente</au><au>Rodríguez-Rojas, Lourdes</au><au>Astray, Jenaro</au><au>Egurrola, Mikel</au><au>Sanz, Francisco</au><au>Castilla, Jesús</au><au>Borrow, Ray</au><aucorp>Working Group of the Project PI12/02079</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of 23-valent pneumococcal polysaccharide vaccination in preventing community-acquired pneumonia hospitalization and severe outcomes in the elderly in Spain</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-02-10</date><risdate>2017</risdate><volume>12</volume><issue>2</issue><spage>e0171943</spage><pages>e0171943-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Pneumococcal pneumonia is a serious cause of morbidity and mortality in the elderly, but investigation of the etiological agent of community-acquired pneumonia (CAP) is not possible in most hospitalized patients. The aim of this study was to estimate the effect of pneumococcal polysaccharide vaccination (PPSV23) in preventing CAP hospitalization and reducing the risk of intensive care unit admission (ICU) and fatal outcomes in hospitalized people aged ≥65 years. We made a multicenter case-control study in 20 Spanish hospitals during 2013-2014 and 2014-2015. We selected patients aged ≥65 years hospitalized with a diagnosis of pneumonia and controls matched by sex, age and date of hospitalization. Multivariate analysis was performed using conditional logistic regression to estimate vaccine effectiveness and unconditional logistic regression to evaluate the reduction in the risk of severe and fatal outcomes. 1895 cases and 1895 controls were included; 13.7% of cases and 14.4% of controls had received PPSV23 in the last five years. The effectiveness of PPSV23 in preventing CAP hospitalization was 15.2% (95% CI -3.1-30.3). The benefit of PPSV23 in avoiding ICU admission or death was 28.1% (95% CI -14.3-56.9) in all patients, 30.9% (95% CI -32.2-67.4) in immunocompetent patients and 26.9% (95% CI -38.6-64.8) in immunocompromised patients. In conclusion, PPSV23 showed a modest trend to avoidance of hospitalizations due to CAP and to the prevention of death or ICU admission in elderly patients hospitalized with a diagnosis of CAP.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28187206</pmid><doi>10.1371/journal.pone.0171943</doi><tpages>e0171943</tpages><orcidid>https://orcid.org/0000-0003-0219-1907</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2017-02, Vol.12 (2), p.e0171943 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1867150937 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Recercat; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Aged Aged, 80 and over Analysis Biology and Life Sciences Care and treatment Case-Control Studies Communities Community-Acquired Infections - epidemiology Community-Acquired Infections - prevention & control Community-Acquired Infections - therapy Diagnosis Disease prevention Etiology Female Geriatrics Hospitalization Hospitalization - statistics & numerical data Humans Immunization Immunocompromised hosts Male Medicine and Health Sciences Morbidity Mortality Multivariate analysis Older people Patients People and Places Persones grans Pneumococcal pneumonia Pneumococcal Vaccines - therapeutic use Pneumonia Pneumonia, Pneumococcal - epidemiology Pneumonia, Pneumococcal - prevention & control Pneumonia, Pneumococcal - therapy Pneumònia Polisacàrids Polysaccharides Prevention Regression analysis Risk reduction Spain Streptococcus infections Streptococcus pneumoniae Treatment outcome Vaccination Vaccination - statistics & numerical data Vaccine efficacy Vaccines Vacunes |
| title | Effectiveness of 23-valent pneumococcal polysaccharide vaccination in preventing community-acquired pneumonia hospitalization and severe outcomes in the elderly in Spain |
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