Abstract

BackgroundPneumonia is a leading infectious cause of morbidity and mortality among adults. Pneumococcal pneumonia (PP) is the most common vaccine-preventable bacterial etiology of pneumonia. In this study, we estimated the incidence of community-acquired pneumonia (CAP) and pneumococcal diseases among Korean adults.MethodsClinical and microbiological databases from three hospitals were retrospectively reviewed to determine the incidence and case fatality rates of CAP and pneumococcal diseases in Korean adults aged ≥19 years from 2011 to 2014. Incidence and case fatality rates of CAP, PP and invasive pneumococcal diseases (IPD) were evaluated based on the catchment population. Catchment population was calculated using national health insurance data, estimating the proportion of patients with pneumonia that were medically attended at each hospital.ResultsAmong 5,783 patients with medically attended CAP, 833 (14.4%) had PP. For IPD, a total of 91 culture-confirmed cases were identified. The overall incidence of CAP was 307.7 cases per 100,000 persons per year with an in-hospital mortality rate of 6.2%. The estimated annual incidence of pneumococcal pneumonia was 42.2–49.4 cases per 100,000 persons per year, increasing with age to >280 per 100,000 persons per year in older patients over 70 years. The annual incidence of IPD had a range of 4.1–6.5 cases per 100,000 persons per year. The overall case fatality rate for invasive pneumococcal diseases was 30.8% with the highest rate of 66.7% in patients over 80 years.ConclusionOver the study period, incidences of CAP, PP and IPD were consistently high, particularly in older people. These results provide baseline data to establish healthcare strategies and estimate their impact among Korean adults.

Highlights

  • Pneumonia is a leading cause of morbidity and mortality worldwide, with 450 million annual cases with 1.3 million annual deaths in children and 1.6 million in adults aged !60 years [1,2,3,4]

  • Incidences of community-acquired pneumonia (CAP), Pneumococcal pneumonia (PP) and invasive pneumococcal disease (IPD) were consistently high, in older people. These results provide baseline data to establish healthcare strategies and estimate their impact among Korean adults

  • Characterization of pneumonia and pneumococcal disease burden is crucial for establishing public health policy, including national immunization programs

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Summary

Introduction

Pneumonia is a leading cause of morbidity and mortality worldwide, with 450 million annual cases with 1.3 million annual deaths in children and 1.6 million in adults aged !60 years [1,2,3,4]. Streptococcus pneumoniae (pneumococcus) is the most common bacterial pathogen causing community-acquired pneumonia (CAP). Annual incidence of CAP is reported to be 520–610 cases per 100,000 adults, increasing in older people [5]. Most studies have suggested that PP incidence might be an important factor for determining the cost effectiveness of pneumococcal vaccination [13,14,15,16]. We estimated the incidence of community-acquired pneumonia (CAP) and pneumococcal diseases among Korean adults

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