Decreases in case-fatality and mortality rates for invasive pneumococcal disease in Olmsted County, Minnesota, during 1995-2007: A population-based study

Constantine Tsigrelis, Imad M. Tleyjeh, Brian D. Lahr, Lisa M. Nyre, Abinash Virk, Larry M. Baddour

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Abstract

Background. Following the introduction of a 7-valent pneumococcal conjugate vaccine for children in 2000, there has been a decrease in the incidence of invasive pneumococcal disease among both children and adults in the United States. We evaluated the hypothesis that the case-fatality and mortality rates for invasive pneumococcal disease have also decreased since 2000. Methods. We conducted a population-based outcome study in Olmsted County, Minnesota, during the period 1995-2007 that involved patients of all ages. Results. From 1 January 1995 through 31 December 2007, a total of 180 eligible cases of invasive pneumococcal disease were identified in Olmsted County. During the 13-year study period, the overall case-fatality rate for invasive pneumococcal disease decreased from 19% (14 of 74 cases) in 1995-1999 to 5% (5 of 91 cases) in 2001-2007, an 83% decrease, after adjustment for age, sex, and Charlson comorbidity index score (P =. 003). The largest decreases in case-fatality rate were seen among adults aged ≥65 years (an 86% decrease, from 31% [9 of 29 cases] to 8% [3 of 40 cases]; P = .02) and patients with invasive pneumonia (a 78% decrease, from 22% [12 of 55 cases] to 7% [5 of 72 cases]; P = .01). The overall mortality rate for invasive pneumococcal disease decreased from 2.9 deaths per 100,000 person-years in 1995-1999 to 0.7 deaths per 100,000 person-years in 2001-2007, a 78%decrease, after adjustment for age and sex in a Poisson regression model (P = .002). Conclusions. Significant decreases in the case-fatality and mortality rates for invasive pneumococcal disease were demonstrated in the population of Olmsted County. Additional studies are needed to confirm our findings in other populations.

Original languageEnglish (US)
Pages (from-to)1367-1371
Number of pages5
JournalClinical Infectious Diseases
Volume47
Issue number11
DOIs
StatePublished - Dec 1 2008

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Mortality
Population
Conjugate Vaccines
Pneumococcal Vaccines
Comorbidity
Pneumonia
Outcome Assessment (Health Care)
Incidence

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

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Decreases in case-fatality and mortality rates for invasive pneumococcal disease in Olmsted County, Minnesota, during 1995-2007 : A population-based study. / Tsigrelis, Constantine; Tleyjeh, Imad M.; Lahr, Brian D.; Nyre, Lisa M.; Virk, Abinash; Baddour, Larry M.

In: Clinical Infectious Diseases, Vol. 47, No. 11, 01.12.2008, p. 1367-1371.

Research output: Contribution to journalArticle

Tsigrelis, Constantine ; Tleyjeh, Imad M. ; Lahr, Brian D. ; Nyre, Lisa M. ; Virk, Abinash ; Baddour, Larry M. / Decreases in case-fatality and mortality rates for invasive pneumococcal disease in Olmsted County, Minnesota, during 1995-2007 : A population-based study. In: Clinical Infectious Diseases. 2008 ; Vol. 47, No. 11. pp. 1367-1371.
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abstract = "Background. Following the introduction of a 7-valent pneumococcal conjugate vaccine for children in 2000, there has been a decrease in the incidence of invasive pneumococcal disease among both children and adults in the United States. We evaluated the hypothesis that the case-fatality and mortality rates for invasive pneumococcal disease have also decreased since 2000. Methods. We conducted a population-based outcome study in Olmsted County, Minnesota, during the period 1995-2007 that involved patients of all ages. Results. From 1 January 1995 through 31 December 2007, a total of 180 eligible cases of invasive pneumococcal disease were identified in Olmsted County. During the 13-year study period, the overall case-fatality rate for invasive pneumococcal disease decreased from 19{\%} (14 of 74 cases) in 1995-1999 to 5{\%} (5 of 91 cases) in 2001-2007, an 83{\%} decrease, after adjustment for age, sex, and Charlson comorbidity index score (P =. 003). The largest decreases in case-fatality rate were seen among adults aged ≥65 years (an 86{\%} decrease, from 31{\%} [9 of 29 cases] to 8{\%} [3 of 40 cases]; P = .02) and patients with invasive pneumonia (a 78{\%} decrease, from 22{\%} [12 of 55 cases] to 7{\%} [5 of 72 cases]; P = .01). The overall mortality rate for invasive pneumococcal disease decreased from 2.9 deaths per 100,000 person-years in 1995-1999 to 0.7 deaths per 100,000 person-years in 2001-2007, a 78{\%}decrease, after adjustment for age and sex in a Poisson regression model (P = .002). Conclusions. Significant decreases in the case-fatality and mortality rates for invasive pneumococcal disease were demonstrated in the population of Olmsted County. Additional studies are needed to confirm our findings in other populations.",
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AB - Background. Following the introduction of a 7-valent pneumococcal conjugate vaccine for children in 2000, there has been a decrease in the incidence of invasive pneumococcal disease among both children and adults in the United States. We evaluated the hypothesis that the case-fatality and mortality rates for invasive pneumococcal disease have also decreased since 2000. Methods. We conducted a population-based outcome study in Olmsted County, Minnesota, during the period 1995-2007 that involved patients of all ages. Results. From 1 January 1995 through 31 December 2007, a total of 180 eligible cases of invasive pneumococcal disease were identified in Olmsted County. During the 13-year study period, the overall case-fatality rate for invasive pneumococcal disease decreased from 19% (14 of 74 cases) in 1995-1999 to 5% (5 of 91 cases) in 2001-2007, an 83% decrease, after adjustment for age, sex, and Charlson comorbidity index score (P =. 003). The largest decreases in case-fatality rate were seen among adults aged ≥65 years (an 86% decrease, from 31% [9 of 29 cases] to 8% [3 of 40 cases]; P = .02) and patients with invasive pneumonia (a 78% decrease, from 22% [12 of 55 cases] to 7% [5 of 72 cases]; P = .01). The overall mortality rate for invasive pneumococcal disease decreased from 2.9 deaths per 100,000 person-years in 1995-1999 to 0.7 deaths per 100,000 person-years in 2001-2007, a 78%decrease, after adjustment for age and sex in a Poisson regression model (P = .002). Conclusions. Significant decreases in the case-fatality and mortality rates for invasive pneumococcal disease were demonstrated in the population of Olmsted County. Additional studies are needed to confirm our findings in other populations.

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