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Invasive pneumococcal disease and the potential for prevention by vaccination in the United Kingdom

Invasive pneumococcal disease and the potential for prevention by vaccination in the United Kingdom
Invasive pneumococcal disease and the potential for prevention by vaccination in the United Kingdom

OBJECTIVES: Invasive pneumococcal disease (IPD) is associated with a high mortality despite antimicrobial therapy, but may be preventable by pneumococcal vaccination. The extent of previous exposure to pneumococcal capsular polysaccharide vaccination prior to an episode of IPD in hospitalised adults in the United Kingdom is unclear.

METHODS: We conducted a retrospective cohort study in adults with IPD admitted to either of two teaching hospitals in Sheffield, United Kingdom during 1992-2000. Receipt of pneumococcal vaccination, risk factors for IPD, death and disability were determined.

RESULTS: The number of cases of IPD was 552 and 187/230 patient records from one site were reviewed. According to UK pneumococcal vaccination guidelines 59% of patients should have received the vaccine and 76% of patients if updated guidelines, which include age>65 years as an indication, are applied. In patients with known risk factors, excluding age, only 8% had been vaccinated. The mortality from IPD was 21% and an additional 6% suffered major complications.

CONCLUSIONS: In patients hospitalised with IPD there is a high rate of pre-existing risk factors and a low rate of administration of pneumococcal vaccination. IPD incurs significant mortality, morbidity and economic cost and there is potential for reducing this by improved uptake of pneumococcal vaccination.

Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Incidence, Male, Middle Aged, Pneumococcal Infections, Pneumococcal Vaccines, Risk Factors, Streptococcus pneumoniae, United Kingdom, Vaccination, Journal Article
0163-4453
435-438
Parsons, H.K.
94fc8c7e-1270-4e24-88c9-141802b3a8b1
Metcalf, S.C.
da9b63ab-54e7-41e1-b2a9-a993a41b62a1
Tomlin, K.
74c2b92f-2c32-4f6b-baba-a89c543194ab
Read, R.C.
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Dockrell, D.H.
a068c9bf-35b8-4c10-8f91-58639cfeca0b
Parsons, H.K.
94fc8c7e-1270-4e24-88c9-141802b3a8b1
Metcalf, S.C.
da9b63ab-54e7-41e1-b2a9-a993a41b62a1
Tomlin, K.
74c2b92f-2c32-4f6b-baba-a89c543194ab
Read, R.C.
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Dockrell, D.H.
a068c9bf-35b8-4c10-8f91-58639cfeca0b

Parsons, H.K., Metcalf, S.C., Tomlin, K., Read, R.C. and Dockrell, D.H. (2007) Invasive pneumococcal disease and the potential for prevention by vaccination in the United Kingdom. Journal of Infection, 54 (5), 435-438. (doi:10.1016/j.jinf.2006.09.002).

Record type: Article

Abstract

OBJECTIVES: Invasive pneumococcal disease (IPD) is associated with a high mortality despite antimicrobial therapy, but may be preventable by pneumococcal vaccination. The extent of previous exposure to pneumococcal capsular polysaccharide vaccination prior to an episode of IPD in hospitalised adults in the United Kingdom is unclear.

METHODS: We conducted a retrospective cohort study in adults with IPD admitted to either of two teaching hospitals in Sheffield, United Kingdom during 1992-2000. Receipt of pneumococcal vaccination, risk factors for IPD, death and disability were determined.

RESULTS: The number of cases of IPD was 552 and 187/230 patient records from one site were reviewed. According to UK pneumococcal vaccination guidelines 59% of patients should have received the vaccine and 76% of patients if updated guidelines, which include age>65 years as an indication, are applied. In patients with known risk factors, excluding age, only 8% had been vaccinated. The mortality from IPD was 21% and an additional 6% suffered major complications.

CONCLUSIONS: In patients hospitalised with IPD there is a high rate of pre-existing risk factors and a low rate of administration of pneumococcal vaccination. IPD incurs significant mortality, morbidity and economic cost and there is potential for reducing this by improved uptake of pneumococcal vaccination.

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More information

Accepted/In Press date: 4 September 2006
e-pub ahead of print date: 17 October 2006
Published date: May 2007
Keywords: Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Incidence, Male, Middle Aged, Pneumococcal Infections, Pneumococcal Vaccines, Risk Factors, Streptococcus pneumoniae, United Kingdom, Vaccination, Journal Article

Identifiers

Local EPrints ID: 416314
URI: https://eprints.soton.ac.uk/id/eprint/416314
ISSN: 0163-4453
PURE UUID: 71a9532e-cbf0-406e-9554-0327c9ade094
ORCID for R.C. Read: ORCID iD orcid.org/0000-0002-4297-6728

Catalogue record

Date deposited: 12 Dec 2017 17:30
Last modified: 14 Mar 2019 01:36

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Contributors

Author: H.K. Parsons
Author: S.C. Metcalf
Author: K. Tomlin
Author: R.C. Read ORCID iD
Author: D.H. Dockrell

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