Pneumococcal serotypes and mortality following invasive pneumococcal disease: a population-based cohort study.
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.
Harboe
Zitta B
ZB
Department of Bacteriology, Statens Serum Institut, Copenhagen. zit@ssi.dk
Thomsen
Reimar W
RW
Riis
Anders
A
Valentiner-Branth
Palle
P
Christensen
Jens Jørgen
JJ
Lambertsen
Lotte
L
Krogfelt
Karen A
KA
Konradsen
Helle B
HB
Benfield
Thomas L
TL
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
D022242:Pneumococcal Vaccines