title: Pneumococcal serotypes and mortality following invasive pneumococcal disease: a population-based cohort study.
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).
  
  
  RESULTS
  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 >or=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.
authors.affiliation: Department of Bacteriology, Statens Serum Institut, Copenhagen. zit@ssi.dk
authors.forename: Zitta B
authors.initials: ZB
authors.lastname: Harboe
authors.forename: Reimar W
authors.initials: RW
authors.lastname: Thomsen
authors.forename: Anders
authors.initials: A
authors.lastname: Riis
authors.forename: Palle
authors.initials: P
authors.lastname: Valentiner-Branth
authors.forename: Jens Jørgen
authors.initials: JJ
authors.lastname: Christensen
authors.forename: Lotte
authors.initials: L
authors.lastname: Lambertsen
authors.forename: Karen A
authors.initials: KA
authors.lastname: Krogfelt
authors.forename: Helle B
authors.initials: HB
authors.lastname: Konradsen
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Benfield
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011008:Pneumococcal Infections / Q000382:microbiology* / Q000401:mortality* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000276:immunology / Q000627:therapeutic use; D015995:Prevalence; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D022242:Pneumococcal Vaccines