Pneumococcal serotypes and mortality following invasive pneumococcal disease: a population-based cohort study

Zitta B Harboe; Reimar W Thomsen; Anders Riis; Palle Valentiner-Branth; Jens Jørgen Christensen; Lotte Lambertsen; Karen A Krogfelt; Helle B Konradsen; Thomas L Benfield

doi:10.1371/journal.pmed.1000081

Pneumococcal serotypes and mortality following invasive pneumococcal disease: a population-based cohort study

Zitta B Harboe, Reimar W Thomsen, Anders Riis, Palle Valentiner-Branth, Jens Jørgen Christensen, Lotte Lambertsen, Karen A Krogfelt, Helle B Konradsen, Thomas L Benfield

Department of Biology

199 Citations (Scopus)

Abstract

BACKGROUND: Pneumococcal disease is a leading cause of morbidity and mortality worldwide. The aim of this study was to investigate the association between specific pneumococcal serotypes and mortality from invasive pneumococcal disease (IPD). METHODS AND FINDINGS: In a nationwide population-based cohort study of IPD in Denmark during 1977-2007, 30-d mortality associated with pneumococcal serotypes was examined by multivariate logistic regression analysis after controlling for potential confounders. A total of 18,858 IPD patients were included. Overall 30-d mortality was 18%, and 3% in children younger than age 5 y. Age, male sex, meningitis, high comorbidity level, alcoholism, and early decade of diagnosis were significantly associated with mortality. Among individuals aged 5 y and older, serotypes 31, 11A, 35F, 17F, 3, 16F, 19F, 15B, and 10A were associated with highly increased mortality as compared with serotype 1 (all: adjusted odds ratio >or=3, p<0.001). In children younger than 5 y, associations between serotypes and mortality were different than in adults but statistical precision was limited because of low overall childhood-related mortality. CONCLUSIONS: Specific pneumococcal serotypes strongly and independently affect IPD associated mortality.

Original language	English
Journal	PLoS Medicine
Volume	6
Issue number	5
Pages (from-to)	e1000081
ISSN	1549-1277
DOIs	https://doi.org/10.1371/journal.pmed.1000081
Publication status	Published - 2009

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title = "Pneumococcal serotypes and mortality following invasive pneumococcal disease: a population-based cohort study",

abstract = "BACKGROUND: Pneumococcal disease is a leading cause of morbidity and mortality worldwide. The aim of this study was to investigate the association between specific pneumococcal serotypes and mortality from invasive pneumococcal disease (IPD). METHODS AND FINDINGS: In a nationwide population-based cohort study of IPD in Denmark during 1977-2007, 30-d mortality associated with pneumococcal serotypes was examined by multivariate logistic regression analysis after controlling for potential confounders. A total of 18,858 IPD patients were included. Overall 30-d mortality was 18%, and 3% in children younger than age 5 y. Age, male sex, meningitis, high comorbidity level, alcoholism, and early decade of diagnosis were significantly associated with mortality. Among individuals aged 5 y and older, serotypes 31, 11A, 35F, 17F, 3, 16F, 19F, 15B, and 10A were associated with highly increased mortality as compared with serotype 1 (all: adjusted odds ratio >or=3, p<0.001). In children younger than 5 y, associations between serotypes and mortality were different than in adults but statistical precision was limited because of low overall childhood-related mortality. CONCLUSIONS: Specific pneumococcal serotypes strongly and independently affect IPD associated mortality.",

author = "Harboe, {Zitta B} and Thomsen, {Reimar W} and Anders Riis and Palle Valentiner-Branth and Christensen, {Jens J{\o}rgen} and Lotte Lambertsen and Krogfelt, {Karen A} and Konradsen, {Helle B} and Benfield, {Thomas L}",

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T1 - Pneumococcal serotypes and mortality following invasive pneumococcal disease: a population-based cohort study

AU - Harboe, Zitta B

AU - Thomsen, Reimar W

AU - Riis, Anders

AU - Valentiner-Branth, Palle

AU - Christensen, Jens Jørgen

AU - Lambertsen, Lotte

AU - Krogfelt, Karen A

AU - Konradsen, Helle B

AU - Benfield, Thomas L

PY - 2009

Y1 - 2009

N2 - BACKGROUND: Pneumococcal disease is a leading cause of morbidity and mortality worldwide. The aim of this study was to investigate the association between specific pneumococcal serotypes and mortality from invasive pneumococcal disease (IPD). METHODS AND FINDINGS: In a nationwide population-based cohort study of IPD in Denmark during 1977-2007, 30-d mortality associated with pneumococcal serotypes was examined by multivariate logistic regression analysis after controlling for potential confounders. A total of 18,858 IPD patients were included. Overall 30-d mortality was 18%, and 3% in children younger than age 5 y. Age, male sex, meningitis, high comorbidity level, alcoholism, and early decade of diagnosis were significantly associated with mortality. Among individuals aged 5 y and older, serotypes 31, 11A, 35F, 17F, 3, 16F, 19F, 15B, and 10A were associated with highly increased mortality as compared with serotype 1 (all: adjusted odds ratio >or=3, p<0.001). In children younger than 5 y, associations between serotypes and mortality were different than in adults but statistical precision was limited because of low overall childhood-related mortality. CONCLUSIONS: Specific pneumococcal serotypes strongly and independently affect IPD associated mortality.

AB - BACKGROUND: Pneumococcal disease is a leading cause of morbidity and mortality worldwide. The aim of this study was to investigate the association between specific pneumococcal serotypes and mortality from invasive pneumococcal disease (IPD). METHODS AND FINDINGS: In a nationwide population-based cohort study of IPD in Denmark during 1977-2007, 30-d mortality associated with pneumococcal serotypes was examined by multivariate logistic regression analysis after controlling for potential confounders. A total of 18,858 IPD patients were included. Overall 30-d mortality was 18%, and 3% in children younger than age 5 y. Age, male sex, meningitis, high comorbidity level, alcoholism, and early decade of diagnosis were significantly associated with mortality. Among individuals aged 5 y and older, serotypes 31, 11A, 35F, 17F, 3, 16F, 19F, 15B, and 10A were associated with highly increased mortality as compared with serotype 1 (all: adjusted odds ratio >or=3, p<0.001). In children younger than 5 y, associations between serotypes and mortality were different than in adults but statistical precision was limited because of low overall childhood-related mortality. CONCLUSIONS: Specific pneumococcal serotypes strongly and independently affect IPD associated mortality.

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DO - 10.1371/journal.pmed.1000081

M3 - Journal article

C2 - 19468297

SN - 1549-1277

VL - 6

SP - e1000081

JO - P L o S Medicine (Online)

JF - P L o S Medicine (Online)

IS - 5

ER -

Pneumococcal serotypes and mortality following invasive pneumococcal disease: a population-based cohort study

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