title: Pneumococcus and the Elderly in Italy: A Summary of Available Evidence Regarding Carriage, Clinical Burden of Lower Respiratory Tract Infections and On-Field Effectiveness of PCV13 Vaccination.
abstract: Streptococcus pneumoniae is currently the leading cause of community-acquired pneumonia (CAP) and lower respiratory tract infections (LRTI) in adults, elderly and high-risk subjects worldwide. The clear benefits of pneumococcal conjugate vaccination in childhood have been accompanied by a decrease of vaccine-serotype invasive diseases among adults in several countries, mainly due to the herd effect mediated by the reduction of vaccine-serotype nasopharyngeal colonization in both age groups, but this reduction in the incidence of pneumonia has not been observed. The "Community Acquired Pneumonia Immunization Trial in Adults" (CAPITA) study provided conclusive evidence about 13-valent pneumococcal conjugate vaccine (PCV13) efficacy in preventing CAP in adults and led Western countries to issue new recommendations for pneumococcal immunization targeting subjects >50 years and high-risk groups, with marked differences with respect to age and/or risk groups immunized, eligibility for reimbursement and national, regional or local implementation. Several Italian regions implemented PCV13 immunization programs in adults and interesting data have been come available in the last years, especially from Liguria, a Northern region with a high and long-lasting pneumococcal vaccine immunological pressure in infants. In this review, currently available evidence from Italy and Liguria regarding pneumococcal carriage, burden of CAP and LRTI, and on-field effectiveness of PCV13 immunization in adults and elderly will be summarized.
authors.affiliation: Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy. andrea.orsi@unige.it.|IRCCS AOU San Martino-IST, 16132 Genoa, Italy. andrea.orsi@unige.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Orsi
authors.affiliation: Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy. filippo.ansaldi@unige.it.|IRCCS AOU San Martino-IST, 16132 Genoa, Italy. filippo.ansaldi@unige.it.
authors.forename: Filippo
authors.initials: F
authors.lastname: Ansaldi
authors.affiliation: Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy. cecilia.trucchi@edu.unige.it.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Trucchi
authors.affiliation: ASL3 Genovese, 16132 Genoa, Italy. roberto.rosselli@asl3.liguria.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Rosselli
authors.affiliation: Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy. icardi@unige.it.|IRCCS AOU San Martino-IST, 16132 Genoa, Italy. icardi@unige.it.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Icardi
mesh_terms: D000328:Adult; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000517:prevention & control*; D013296:Streptococcus pneumoniae / Q000187:drug effects; D014611:Vaccination
chemical_list: C538862:13-valent pneumococcal vaccine; D022242:Pneumococcal Vaccines
keywords: CAP; LRTI; PCV13; Streptococcus pneumoniae; effectiveness; elderly; pharyngeal carriage; pneumococcal conjugate vaccines