Annual Incidence Of Community-acquired Pneumonia Research Articles

Community-Acquired Pneumonia Incidence in Adults Aged 18 Years and Older in Goto City, Japan: A Prospective Population-Based Study

Community-Acquired Pneumonia Incidence in Adults Aged 18 Years and Older in Goto City, Japan: A Prospective Population-Based Study

Pneumococcal infection in Russia: state of the issue

Background: Pneumococcal disease is common cause of morbidity and mortality in adults and children worldwide. The severity of pneumococcal diseases determines their high socio-economic significance.
 Aims: Estimate the burden of pneumococcal infection and vaccination coverage in Russia.
 Methods: The data was obtained from federal surveillance system. The information obtained was analyzed using descriptive statistics methods.
 Results: The annual incidence of community-acquired pneumonia in Russia was 491.7/100000 in 2011-2019. It ranges from 359.8/100000 among adults of working age to 1505.4/100000 among children 1-2 years old. The upward trend of incidence is observed throughout the period, most expressive among school-age children (7-17 years old). Total 29.2% of all pneumonia have an identified etiology. 94% of pneumonia with known etiology are bacterial, 8.4% among it are pneumococcal.
 Pneumonia accounts for 57% of all deaths from respiratory diseases among children under five (3.7/100000) and 34% among elderly. The death rate from pneumonia in 2009-2018 tends to decrease. In 2018, 25.5 thousand deaths from pneumonia were registered (17.5/100000). The highest rate is observed among children under one year (14.0 /100000) and elderly (41.2 /100000).
 There is a downward trend in incidence of otitis media. The incidence in children under 14 was 2612.6/100 000 in 2018. The incidence of bacterial meningitis is 1.4/100 000. Every year 2-3 thousand cases are registered, 43-52% of which are among children (3.04/100000., maximally in children under one year old, 13.2/100000).
 The level of vaccination against pneumococcal infection is increasing annually, but the proportion of children who have received a completed course of vaccination remains insufficient (64.6% in 2019). Coverage among the adult population was 2.3% (3.8% among those over 60). The main contingents of vaccinated adults are conscripts (coverage 67.4%) and people with chronic lung diseases (coverage 15.1%).
 Conclusions: The socio-economic and epidemiological burden of diseases associated with pneumococcal infection in Russia remains high. Accurate assessment of morbidity and mortality rates caused by St. pneumoniae diseases isnt possible due to the insufficient level of their ethological identification. Further efforts are required to achieve high level of herd immunity against pneumococcal infection through vaccine prevention during COVID-19 pandemic.

The Burden of Community-Acquired Pneumonia Requiring Admission to ICU in the United States

A paucity of studies have assessed the epidemiology of community-acquired pneumonia (CAP) that require ICU admission. We conducted a study on this group of patients with the primary objective of defining the incidence, epidemiology, and mortality rate of CAP in the ICUs in Louisville, Kentucky. The secondary objective was to estimate the number of patients who were hospitalized and the number of deaths that were associated with CAP in ICU in the United States. What is epidemiology of CAP in the ICU in Louisville, Kentucky, and the projected incidence in the United States? This was a secondary analysis of a prospective population-based cohort study. The setting was all nine adult hospitals in Louisville, Kentucky. The annual incidence of CAP in the ICU per 100,000 adults was calculated for the whole adult population of Louisville. The number of patients who were hospitalized because of CAP in ICU in the United States was estimated by multiplying the Louisville incidence rate of CAP in ICU by the 2014 US adult population. From a total of 7,449 unique patients who were hospitalized with CAP, 1,707 patients (23%) were admitted to the ICU. The incidence of CAP in the ICU was 145 cases per 100,000 population of adults. Cases of CAP in the ICU were clustered in patients from areas of the city with high poverty. The mortality rate of patients with CAP in ICU was 27%at 30days and 47%at one year. In the United States, the estimated number of patients who were hospitalized with CAP requiring the ICU was 356,326 per year, and the estimated number of deaths at 30days and one year were 96,206 and 167,474, respectively. Almost one in five patients who are hospitalized with CAP requires intensive care. Poverty is associated with CAP in the ICU. Nearly one-half of patients with CAP in the ICU will die within one year. Because of its significant burden, CAP in the ICU should be a high priority in research agenda and health policy.

2718. Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine in US Adults Hospitalized with Pneumonia, 2014–2017

BackgroundEfficacy of 13-valent pneumococcal conjugate vaccine (PCV13) against pneumococcal pneumonia in adults aged >65 years was shown in a 2014 clinical trial. However, its benefits in countries with a mature PCV infant program remain unclear. In August 2014, PCV13 was recommended for all US adults aged >65 years. We evaluated the direct effect of this recommendation on pneumonia hospitalizations among the elderly.MethodsWe analyzed claims data from US Medicare beneficiaries aged >65 years enrolled in part A/B during September 1, 2014 through December 31, 2017. Participants were followed until they died, left part A/B, or developed a study outcome: community-acquired pneumonia (CAP), non-healthcare-associated CAP (non-HA CAP) or lobar pneumonia (LP). We identified outcomes using inpatient diagnosis codes, and vaccination status using procedure codes. We used discrete-time survival models, stratified by influenza season (October–April) and influenza vaccination status, to estimate incidence rate ratios (IRR) by pneumococcal vaccination status (PCV13-only vs. no pneumococcal vaccination). We adjusted for demographic factors, healthcare utilization, month/year of hospital discharge, and underlying conditions. We derived vaccine effectiveness (VE) and number of hospitalizations averted by PCV13 from the IRRs.ResultsOf 26.6 million beneficiaries in September 2014, 43.4% were male, 54.2% were aged 65–74 years, and 28.9% had a Charlson comorbidity score >3. PCV13 coverage increased from 0.8% in September 2014 to 41.5% in December 2017. Annual incidence of CAP, non-HA CAP, and LP are shown in the figure. PCV13-vaccinated persons were more likely to be older, sicker, and have received flu vaccine than unvaccinated persons. VE estimates for CAP, non-HA CAP, and LP ranged from 6.0–11.4%, 5.0–11.0%, and 1.3–11.0%, respectively. From September 2014 to December 2017, an estimated 28,600 (95% CI: 21,000–36,000) CAP, 18,700 (12,000–25,800) non-HA CAP and 1,100 (190–1,900) LP hospitalizations were averted.ConclusionWithin 40 months after implementation of the adult PCV13 program, 2.0% (28,600) of US CAP hospitalizations were averted. Despite PCV13 effectiveness against adult CAP, only a small fraction of CAP hospitalizations was prevented. Disclosures All authors: No reported disclosures.

736. Incidence and Etiology of Community-Acquired Pneumonia Requiring Hospitalization Among American Indian/Alaskan Native Adults

BackgroundA leading infectious cause of hospitalization among adults in the United States is community-acquired pneumonia (CAP). The etiology and incidence of CAP in American Indians/Alaskan Natives (AI/AN) has not been described.MethodsWe conducted a retrospective study by reviewing the medical records of all AI/AN patients 18 years or older admitted to W.W. Hastings Hospital in Tahlequah, Oklahoma with a diagnosis of a respiratory infection from January 1, 2016 to December 31, 2016. Only patients with a radiographically confirmed CAP were included and those with a recent hospitalization or immunosuppressed were excluded. Patient demographics, comorbidities and results of molecular tests, antigen detection, high quality sputum culture and blood culture were reviewed. Population-based incidence rates of CAP requiring hospitalization were calculated according to age.ResultsFrom January 2016 through December 2016, 763 patients were admitted with a diagnosis of a respiratory infection, of which 193 (25%) met the inclusion criteria. Of this group, 103 (53%) had at least one pathogen detected: one or more viruses were detected in 47 (24%), one or more bacteria were detected in 63 (33%). The most common pathogens were Streptococcus pneumoniae (12% of patients), rhinovirus/enterovirus (11% of patients), respiratory syncytial virus (5% of patients), legionella pneumophila (4% of patients), and human metapneumovirus (4% of patients). The annual incidence of CAP was 13.6 cases (95% confidence interval, 11.9, 15.7) per 10,000 adults, with the highest incidence among adults ages 65–79 (43 cases per 10,000 adults) and those 80 years of age or older (102 cases per 10,000 adults). Seventy-five percent of patients had an underlying medical condition, 47% had diabetes mellitus (DM), followed by chronic obstructive lung disease (38%) and chronic heart disease (32%).ConclusionIn this AI/AN population, a respiratory pathogen was identified in 53% of the cases despite the use of cutting edge diagnostic tests in most patients. Bacteria were detected more often than viruses. Compared with recent publications of CAP affecting non-Hispanic whites, non-Hispanic blacks and Hispanics, the population described in this study was older and had higher prevalence of DM.Disclosures All authors: No reported disclosures.

Incidence and risk factor prevalence of community-acquired pneumonia in adults in primary care in Spain (NEUMO-ES-RISK project).

BackgroundCommunity-acquired pneumonia (CAP) is a major cause of morbidity and mortality in adults even in developed countries. Several lifestyle factors and comorbidities have been linked to an increased risk, although their prevalence has not been well documented in the primary care setting. The aim of this study is to assess the incidence, risk factor and comorbid conditions distribution of CAP in adults in primary care in Spain.MethodsRetrospective observational study in adults (>18 years-old) with CAP diagnosed and attended at primary care in Spain between 2009 and 2013, using the Computerized Database for Pharmacoepidemiological Studies in Primary Care (BIFAP).ResultsTwenty-eight thousand four hundred thirteen patient records were retrieved and analyzed. Mean age (standard deviation): 60.5 (20.3) years, 51.7 % males. Global incidence of CAP in adults was estimated at 4.63 per 1000 persons/year. CAP incidence increased progressively with age, ranging from a 1.98 at 18–20 years of age to 23.74 in patients over 90 years of age. According to sex, global CAP incidence was slightly higher in males (5.04) than females (4.26); CAP incidence from 18 to 65 year-olds up was comparable between males (range: 2.18–5.75) and females (range: 1.47–5.21), whereas from 65 years of age, CAP incidence was noticeable higher in males (range: 7.06–36.93) than in females (range: 5.43–19.62). Average prevalence of risk factors was 71.3 %, which increased with age, doubling the risk in males by the age of 75 (females 20 % vs males 40 %). From 55 years of age, at least one risk factor was identified in 85.7 % of cases: one risk factor (23.8 %), two risk factors (23.4 %), three or more risk factors (38.5 %). Major risk factors were: metabolic disease (27.4 %), cardiovascular disease (17.8 %) and diabetes (15.5 %).ConclusionsThe annual incidence of CAP in primary care adults in Spain is high, comparable between males and females up to 65 years of age, but clearly increasing in males from that age. CAP risk increases with age and doubles in males older than 75 years. The majority of CAP cases in patients over 55 years of age is associated to at least one risk factor. The main risk factors associated were metabolic disease, cardiovascular disease, and diabetes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1974-4) contains supplementary material, which is available to authorized users.

Community-acquired pneumonia related to intracellular pathogens.

Community-acquired pneumonia (CAP) is associated with high rates of morbidity and mortality worldwide; the annual incidence of CAP among adults in Europe has ranged from 1.5 to 1.7 per 1000 population. Intracellular bacteria are common causes of CAP. However, there is considerable variation in the reported incidence between countries and change over time. The intracellular pathogens that are well established as causes of pneumonia are Legionella pneumophila, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Chlamydophila psittaci, and Coxiella burnetii. Since it is known that antibiotic treatment for severe CAP is empiric and includes coverage of typical and atypical pathogens, microbiological diagnosis bears an important relationship to prognosis of pneumonia. Factors such as adequacy of initial antibiotic or early de-escalation of therapy are important variables associated with outcomes, especially in severe cases. Intracellular pathogens sometimes appear to cause more severe disease with respiratory failure and multisystem dysfunction associated with fatal outcomes. The clinical relevance of intracellular pathogens in severe CAP has not been specifically investigated. We review the prevalence, general characteristics, and outcomes of severe CAP cases caused by intracellular pathogens.

Passive smoking at home is a risk factor for community-acquired pneumonia in older adults: a population-based case–control study

ObjectiveTo assess whether passive smoking exposure at home is a risk factor for community-acquired pneumonia (CAP) in adults.SettingA population-based case-control study was designed in a Mediterranean area with 860 000...

Severe Community-Acquired Pneumonia (CAP) due to Atypical Pathogens

Community-acquired pneumonia (CAP) is a relatively common and potentially serious infection that affects both immunocompetent and immunosuppressive adults throughout the world. The annual incidence of CAP in the United States is approximately 4 million cases. CAP due to atypical pathogens accounts for approximately 20 to 40 percent of cases necessitating hospitalization. There are few data regards to the prevalence rates of severe CAP due to atypical pathogens necessitating admission to the intensive care unit. This review article summarizes clinical features, diagnostic criteria, differential diagnosis, and management based on guidelines of medical societies. Keywords: Community-acquired pneumonia, atypical pathogens, legionella, mycoplasma, chlamydia, intensive care unit