Epidemiology of Invasive Streptococcus pneumoniae Infections in the United States, 1995-1998: Opportunities for Prevention in the Conjugate Vaccine Era

摘要: ContextPneumococcal polysaccharide vaccine is recommended for elderly persons and adults with certain chronic illnesses. Additionally, a recently licensed pneumococcal 7-valent conjugate has been use in young children and could dramatically change the epidemiology of pneumococcal disease.ObjectivesTo assess disease burden United States, estimate the potential impact new vaccines, identify gaps recommendations.Design SettingAnalysis data from Active Bacterial Core Surveillance (ABCs)/Emerging Infections Program Network, an active, population-based system 9 states.PatientsA total 15 860 cases invasive occurring between January 1, 1995, December 31, 1998.Main Outcome MeasuresAge- race-specific pneumoccocal incidence rates per 100 000 persons, case-fatality rates, preventability.ResultsIn 1998, overall was 23.2 100 000, corresponding to estimated 62 840 States. Incidence highest among children younger than 2 years (166.9) aged 65 or older (59.7). among blacks 2.6 times higher whites (95% confidence interval [CI], 2.4-2.8). Overall, 28.6% case-patients were at least old 85.9% this age group due to serotypes included 23-valent vaccine; 19.3% were younger 82.2% vaccine. Among patients 64 years, 50.6% had indication as defined by Advisory Committee on Immunization Practices (ACIP). The rate 18 years with ACIP 12.1% compared 5.4% those without an indication (relative risk, 2.2; 95% CI, 1.7-2.9).ConclusionsYoung children, persons, black persons all ages are disproportionately affected disease. Current recommendations do not address subset but do include at highest risk death