title: Pneumococcal pneumonia in adults 60 years or older: Incidence, mortality and prevention.
abstract: BACKGROUND
  This study investigated the burden (incidence, mortality and serotype distribution) of pneumococcal pneumonia among older adults in the region of Tarragona (Spain).
  
  
  METHODS
  Population-based cohort study involving 27,204 individuals ≥60 years in Tarragonès county (Southern Catalonia), who were prospectively followed between 01/12/2008 and 30/11/2011. Bacteremic and nonbacteremic (positive sputum culture and/or urinary antigen test) pneumococcal pneumonias were recruited.
  
  
  RESULTS
  A total of 125 pneumococcal pneumonias (16 bacteremic and 109 nonbacteremic) was observed. Incidence rates (per 1000 person-years) were 0.21 (95% confidence interval [CI]: 0.13-0.35) for bacteremic cases and 1.45 (95% CI: 1.20-1.75) for nonbacteremic cases. Case-fatality rate was 10.4% (12.5% in bacteremic and 10.1% in nonbacteremic cases). Five serotypes (types 3, 6C, 19A, 22F and 35B) were the most common serotypes, accounting for 64.3% of overall isolated serotypes. 73.1% of cases were due to the strains included in the 23-valent vaccine whereas 53.6% were due to the strains included in the 13-valent vaccine.
  
  
  CONCLUSIONS
  The burden of pneumococcal pneumonia remains considerable (especially among oldest people and nursing-home residents) despite a publicly funded anti-pneumococcal vaccination program operative for several years.
authors.affiliation: Servicio de Atención Primaria Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Vila-Corcoles
authors.affiliation: Servicio de Atención Primaria Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain.
authors.forename: Xabier
authors.initials: X
authors.lastname: Ansa
authors.affiliation: Servicio de Atención Primaria Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain. Electronic address: oochoa.tarte.ics@gencat.cat.
authors.forename: Olga
authors.initials: O
authors.lastname: Ochoa-Gondar
authors.affiliation: Servicio de Atención Primaria Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Satue
authors.affiliation: Servicio de Atención Primaria Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain.
authors.forename: Cinta
authors.initials: C
authors.lastname: de Diego
authors.affiliation: Instituto Universitario de Investigación en Atención Primaria Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Rodriguez-Blanco
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D011446:Prospective Studies; D065288:Serogroup; D013030:Spain / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000145:classification
chemical_list: D022242:Pneumococcal Vaccines
keywords: Epidemiology; Epidemiología; Incidence; Incidencia; Letalidad; Mortality; Neumonía neumocócica; Pneumococcal pneumonia; Streptococcus pneumoniae