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Pneumococcal Serotypes and Mortality following Invasive Pneumococcal Disease: A Population-Based Cohort Study
Authors:Zitta B Harboe  Reimar W Thomsen  Anders Riis  Palle Valentiner-Branth  Jens J?rgen Christensen  Lotte Lambertsen  Karen A Krogfelt  Helle B Konradsen  Thomas L Benfield
Institution:1.Department of Bacteriology, Mycology, and Parasitology, Statens Serum Institut, Copenhagen;2.Department of Clinical Epidemiology, Aarhus University Hospital, Aalborg;3.Department of Epidemiology, Statens Serum Institut, Copenhagen;4.Department of Infectious Diseases and Clinical Research Centre, Hvidovre University Hospital, Copenhagen;5.Faculty of Health Sciences, University of Copenhagen, Copenhagen;Emory University, United States of America
Abstract:

Background

Pneumococcal disease is a leading cause of morbidity and mortality worldwide. The aim of this study was to investigate the association between specific pneumococcal serotypes and mortality from invasive pneumococcal disease (IPD).

Methods and Findings

In a nationwide population-based cohort study of IPD in Denmark during 1977–2007, 30-d mortality associated with pneumococcal serotypes was examined by multivariate logistic regression analysis after controlling for potential confounders. A total of 18,858 IPD patients were included. Overall 30-d mortality was 18%, and 3% in children younger than age 5 y. Age, male sex, meningitis, high comorbidity level, alcoholism, and early decade of diagnosis were significantly associated with mortality. Among individuals aged 5 y and older, serotypes 31, 11A, 35F, 17F, 3, 16F, 19F, 15B, and 10A were associated with highly increased mortality as compared with serotype 1 (all: adjusted odds ratio ≥3, p<0.001). In children younger than 5 y, associations between serotypes and mortality were different than in adults but statistical precision was limited because of low overall childhood-related mortality.

Conclusions

Specific pneumococcal serotypes strongly and independently affect IPD associated mortality.
Keywords:
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