Adult invasive pneumococcal disease in the Republic of Korea: Risk medical conditions and mortality stratified by age group

Jong Hun Kim, Seung Hee Baik, Byung-Chul Chun, Joon-Young Song, In Gyu Bae, Hyo Youl Kim, Dong Min Kim, Young Hwa Choi, Wonseok Choi, Yu Mi Jo, Hyun Hee Kwon, Hye Won Jeong, Yeon Sook Kim, Jeong Yeon Kim, Jacob Lee, Sae Yoon Kee, Jian Hur, Jin Won Chung, Ki Eun Hwang, Ja Kim Min

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives: This study aimed to characterize the risk factors for mortality in adult patients with invasive pneumococcal disease (IPD) stratified by age groups, after implementation of the national immunization program of 23-valent polysaccharide vaccine (PPSV23) for those aged ≥65 years in the Republic of Korea (ROK). Methods: Clinical data and pneumococcal isolates from adult patients with IPD (≥18 years of age) were collected prospectively from 20 hospitals through the nationwide surveillance program from March 2013 to October 2015. Results: A total of 319 patients with IPD were enrolled. Median age was 69 years. Overall in-hospital mortality was 34.2%: 17.1% in those aged 18–49 years, 23.7% in those aged 50–64 years, 33.0% in those aged 65–74 years, and 51.0% in those aged ≥75 years (p < 0.001). In particular, early death within 7 days of hospitalization accounted for 60.6% (66/109). While old age (≥65 years), higher Pitt bacteremia score (≥4), and bacteremic pneumonia were independently associated with IPD mortality in all age groups, an additional mortality risk factor of immunocompromised status was identified for patients aged 50–64 years. PPSV23 serotypes accounted for 64.4% (122/189) of the pneumococcal isolates serotyped. Conclusions: This study suggests that vaccine-type IPD continues to place a substantial burden on older adults in the ROK, necessitating an effective vaccination strategy for those at higher risk.

Original languageEnglish
Pages (from-to)136-144
Number of pages9
JournalInternational Journal of Infectious Diseases
Volume74
DOIs
Publication statusPublished - 2018 Sep 1

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Republic of Korea
Age Groups
Mortality
Immunization Programs
Pneumococcal Vaccines
Bacteremia
Hospital Mortality
Polysaccharides
Pneumonia
Vaccination
Hospitalization

Keywords

  • Adult
  • Invasive pneumococcal disease
  • Mortality
  • Risk factors

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Adult invasive pneumococcal disease in the Republic of Korea : Risk medical conditions and mortality stratified by age group. / Kim, Jong Hun; Baik, Seung Hee; Chun, Byung-Chul; Song, Joon-Young; Bae, In Gyu; Kim, Hyo Youl; Kim, Dong Min; Choi, Young Hwa; Choi, Wonseok; Jo, Yu Mi; Kwon, Hyun Hee; Jeong, Hye Won; Kim, Yeon Sook; Kim, Jeong Yeon; Lee, Jacob; Kee, Sae Yoon; Hur, Jian; Chung, Jin Won; Hwang, Ki Eun; Min, Ja Kim.

In: International Journal of Infectious Diseases, Vol. 74, 01.09.2018, p. 136-144.

Research output: Contribution to journalArticle

Kim, JH, Baik, SH, Chun, B-C, Song, J-Y, Bae, IG, Kim, HY, Kim, DM, Choi, YH, Choi, W, Jo, YM, Kwon, HH, Jeong, HW, Kim, YS, Kim, JY, Lee, J, Kee, SY, Hur, J, Chung, JW, Hwang, KE & Min, JK 2018, 'Adult invasive pneumococcal disease in the Republic of Korea: Risk medical conditions and mortality stratified by age group', International Journal of Infectious Diseases, vol. 74, pp. 136-144. https://doi.org/10.1016/j.ijid.2018.07.018
Kim, Jong Hun ; Baik, Seung Hee ; Chun, Byung-Chul ; Song, Joon-Young ; Bae, In Gyu ; Kim, Hyo Youl ; Kim, Dong Min ; Choi, Young Hwa ; Choi, Wonseok ; Jo, Yu Mi ; Kwon, Hyun Hee ; Jeong, Hye Won ; Kim, Yeon Sook ; Kim, Jeong Yeon ; Lee, Jacob ; Kee, Sae Yoon ; Hur, Jian ; Chung, Jin Won ; Hwang, Ki Eun ; Min, Ja Kim. / Adult invasive pneumococcal disease in the Republic of Korea : Risk medical conditions and mortality stratified by age group. In: International Journal of Infectious Diseases. 2018 ; Vol. 74. pp. 136-144.
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abstract = "Objectives: This study aimed to characterize the risk factors for mortality in adult patients with invasive pneumococcal disease (IPD) stratified by age groups, after implementation of the national immunization program of 23-valent polysaccharide vaccine (PPSV23) for those aged ≥65 years in the Republic of Korea (ROK). Methods: Clinical data and pneumococcal isolates from adult patients with IPD (≥18 years of age) were collected prospectively from 20 hospitals through the nationwide surveillance program from March 2013 to October 2015. Results: A total of 319 patients with IPD were enrolled. Median age was 69 years. Overall in-hospital mortality was 34.2{\%}: 17.1{\%} in those aged 18–49 years, 23.7{\%} in those aged 50–64 years, 33.0{\%} in those aged 65–74 years, and 51.0{\%} in those aged ≥75 years (p < 0.001). In particular, early death within 7 days of hospitalization accounted for 60.6{\%} (66/109). While old age (≥65 years), higher Pitt bacteremia score (≥4), and bacteremic pneumonia were independently associated with IPD mortality in all age groups, an additional mortality risk factor of immunocompromised status was identified for patients aged 50–64 years. PPSV23 serotypes accounted for 64.4{\%} (122/189) of the pneumococcal isolates serotyped. Conclusions: This study suggests that vaccine-type IPD continues to place a substantial burden on older adults in the ROK, necessitating an effective vaccination strategy for those at higher risk.",
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AU - Kim, Jong Hun

AU - Baik, Seung Hee

AU - Chun, Byung-Chul

AU - Song, Joon-Young

AU - Bae, In Gyu

AU - Kim, Hyo Youl

AU - Kim, Dong Min

AU - Choi, Young Hwa

AU - Choi, Wonseok

AU - Jo, Yu Mi

AU - Kwon, Hyun Hee

AU - Jeong, Hye Won

AU - Kim, Yeon Sook

AU - Kim, Jeong Yeon

AU - Lee, Jacob

AU - Kee, Sae Yoon

AU - Hur, Jian

AU - Chung, Jin Won

AU - Hwang, Ki Eun

AU - Min, Ja Kim

PY - 2018/9/1

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N2 - Objectives: This study aimed to characterize the risk factors for mortality in adult patients with invasive pneumococcal disease (IPD) stratified by age groups, after implementation of the national immunization program of 23-valent polysaccharide vaccine (PPSV23) for those aged ≥65 years in the Republic of Korea (ROK). Methods: Clinical data and pneumococcal isolates from adult patients with IPD (≥18 years of age) were collected prospectively from 20 hospitals through the nationwide surveillance program from March 2013 to October 2015. Results: A total of 319 patients with IPD were enrolled. Median age was 69 years. Overall in-hospital mortality was 34.2%: 17.1% in those aged 18–49 years, 23.7% in those aged 50–64 years, 33.0% in those aged 65–74 years, and 51.0% in those aged ≥75 years (p < 0.001). In particular, early death within 7 days of hospitalization accounted for 60.6% (66/109). While old age (≥65 years), higher Pitt bacteremia score (≥4), and bacteremic pneumonia were independently associated with IPD mortality in all age groups, an additional mortality risk factor of immunocompromised status was identified for patients aged 50–64 years. PPSV23 serotypes accounted for 64.4% (122/189) of the pneumococcal isolates serotyped. Conclusions: This study suggests that vaccine-type IPD continues to place a substantial burden on older adults in the ROK, necessitating an effective vaccination strategy for those at higher risk.

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