成年人肺炎球菌肺炎的发病率和危险因素:基于人口的研究
Olga Ochoa-Gondar1, Verónica Torras-Vives1, Cinta de Diego-Cabanes2,3
1Primary Health Care Service "Camp de Tarragona", Institut Català de la Salut, Tarragona, Spain.
50岁以上的个体以前患有侵入性肺炎球菌病 (IPD) 或肺炎,慢性呼吸道疾病或多种并发症,面临着明显更高的肺炎球菌肺炎 (PP) 风险. 这些因素,以及免疫功能受损的情况,需要对高风险PP类别进行重新评估,以加强预防策略.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 传染性疾病 传染性疾病
背景情况:
- 链球杆菌肺炎感染,包括侵入性肺炎球菌病 (IPD) 和肺炎球菌肺炎 (PP),对全球健康造成重大负担.
- 了解老年人中PP的发病率和风险因素,特别是那些患有潜在疾病的人,对于公共卫生干预至关重要.
研究的目的:
- 调查西班牙加泰罗尼亚50岁及以上的人群中肺炎球菌性肺炎 (PP) 发生率和风险.
- 检查单一和多重并发症对该人口群体中发展PP的风险的影响.
主要方法:
- 一项基于人口的队列研究追溯分析了2017年至2018年间加泰罗尼亚50岁以上的2,059,645名50岁以上个体的数据.
- 从SIDIAP信息系统获得了基线特征和并发症.
- 从医院出院记录中使用ICD-10代码J13识别PP病例.
主要成果:
- PP的总发病率为每10万人/年有90.7例,病例死亡率为7.6%.
- 在有先前IPD或全因肺炎,艾滋病毒感染,血液瘤和病史的人群中观察到最高的发病率.
- 随着并发症数量的增加,PP的风险显著增加,具有五种或更多并发症的个体表现出最高的发病率 (761.2每10万人年).
结论:
- 以前的IPD或肺炎病史,慢性呼吸道疾病和多种并发病被确定为50岁以上成年人PP的主要风险因素.
- 与这些疾病相关的过度风险与免疫受损个体的风险相当.
- 修订PP的风险类别以包括这些因素可以改善中年和老年人的预防策略.
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