侵袭性肺炎球菌疾病的疾病趋势和死亡率:一项基于人口的长期研究
Hörður Tryggvi Bragason1,2, Kristján Godsk Rögnvaldsson1,2, Ubaldo Benitez Hernandez3
1Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
侵入性肺炎球菌病 (IPD) 发病率下降,但短期死亡率保持不变. 肺炎球菌性肺炎的幸存者面临着显著更高的长期死亡率,这凸显了针对性干预的必要性.
科学领域:
- 传染性疾病 传染性疾病
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 在全球范围内,Streptococcus pneumoniae导致严重的侵入性肺炎球菌病 (IPD) 和死亡率.
- 肺炎球菌联合疫苗 (PCV) 在许多地区降低了IPD发病率.
- IPD幸存者的长期死亡趋势没有得到充分的记录.
研究的目的:
- 分析冰岛IPD幸存者的长期死亡趋势.
- 为了比较IPD患者和普通人群之间的全因死亡率.
- 评估PCV引入对IPD死亡率的影响.
主要方法:
- 在冰岛 (1975-2020年) 分析了所有阳性血液/心血管菌培养的IPD病例.
- 在三十年 (1985-2014) 期间评估30天和5年死亡率.
- 在IPD患者和一般人群之间,年龄标准化全因死亡率 (ASR) 的比较.
主要成果:
- IPD发病率在1995-2004年达到顶峰,并在2011年后显著下降 (p<.001).
- 随着时间的推移,30天死亡率没有显著改善 (p=.98).
- 与一般人群相比,IPD幸存者在全因死亡率上有2.6倍的ASR (0.021比0.008人/年).
结论:
- 尽管IPD发病率下降,但短期死亡率并没有改善.
- 5年死亡率的适度,不显著的改善表明慢性疾病管理的潜在好处.
- IPD幸存者经历了大幅增加的长期死亡率,需要有针对性的干预措施来减少急性和长期风险.
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