scholarly journals 1309. Incidence and Epidemiology of Invasive Pneumococcal Disease due to Serotype 3 in South-Central Ontario

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S743-S743
Author(s):  
Allison McGeer ◽  
Agron Plevneshi ◽  
Kazi Hassan ◽  
Wayne Gold ◽  
Larissa Matukas ◽  
...  
Keyword(s):  
Older Adults ◽  
Invasive Pneumococcal Disease ◽  
Case Fatality Rate ◽  
Pneumococcal Disease ◽  
Case Fatality ◽  
Population Based ◽  
Fatality Rate ◽  
South Central ◽  
Study Laboratory ◽  
Over Time

Abstract Background In our population, the most common serotype (ST) of S. pneumoniae causing invasive pneumococcal disease (IPD) is now ST 3. We undertook an analysis of population based surveillance for IPD to examine the incidence and epidemiology of ST 3 disease over the last 25 years. Methods The Toronto Invasive Bacterial Diseases Network has performed population-based surveillance for IPD in Toronto/Peel region (pop’n 4.5M) since 1995. All sterile site isolates of S. pneumoniae are reported to a central study laboratory, isolates are serotyped, and clinical and vaccination data are collected via patient and physician interview and chart review. Population data are obtained from Statistics Canada. Results From 1995-2020, 11032 episodes of IPD occurred; 10015 had STs available, and 10484 clinical data. Overall, ST 3 comprised 9.2% of cases (N=931). Compared to other patients with IPD, those with ST 3 IPD were older (median age 65 vs. 58.5, P< .001), more likely to have underlying lung (22.7% v 16.0%, P< .0001) and cardiac (21.7 v 18.4, P=.02) disease and less likely to be immunocompromised (IC) (23.1% v 29.0% P< .0001). ST3 episodes were more likely to be pneumonia (81% v 65%), less likely to be bacteremia without focus (7.6% v 18.9%), and more likely to require ICU admission (42.3% v 25.1%) and to die (27.1% v 16.6%). In multivariable analysis, patients with ST 3 disease remained more likely to die (OR 1.65; 95%CI1.3-2.0). Over time, the proportion of patients with ST 3 IPD who were nursing home (NH) residents (18/171 in 1995-2000 vs. 4/215 in 2016-2020, P=.0002), and who were IC (46/169 in 1995-2000 vs 39/204 in 2016-2020, P=.007) decreased significantly; in IPD due to other STs, the proportion who were NH residents declined, but the proportion IC increased significantly. The case fatality rate (CFR) declined significantly in IPD due to ST3 but not other STs (Figure 1). Changes in incidence are shown in Figure 2. Figure 2: Incidence of serotype 3 IPD over time, Toronto/Peel, 1995-2020 The incidence of ST3 IPD in children and adults under 65 did not change significantly from 1995/96 to 2019/20. In older adults, the annual incidence of disease declined from 4.98 per 100,000 per year in 1995-2000 to 3.53 per 100,000 per year in 2001-2010 (IRR 0.71, 95%CI 0.56-0.90), then to 2.23 per 100,000 per year in 2011-2020 (IRR compared to 2001-2010 0.63, 95%CI 0.50-0.79) FIgure 2: Case fatality rate of IPD due to serotype 3 and other serotypes over time, 1995-2020, Toronto-Peel The case fatality rate of IPD due to ST3 declined from 37.6% (56/149) in 1995-2000 to 50/235 (21.3%) in 2015-2020 (P<.0001). The CFR in other serotypes did not change. Conclusion The epidemiology of IPD due to ST3 has changed significantly over time and the CFR has declined. The incidence of ST3 disease in children and younger adults has not changed significantly, although the power to detect change is low in children. In older adults the incidence of ST3 disease declined significantly after PPV23 introduction in 1995/6 and again after PCV13 introduction for children. Disclosures All Authors: No reported disclosures

scholarly journals Decreasing case fatality rate following invasive pneumococcal disease, North East England, 2006–2016

2019 ◽  
Vol 147 ◽  
Author(s):  
C. Houseman ◽  
K. E. Chapman ◽  
P. Manley ◽  
R. Gorton ◽  
D. Wilson ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Case Fatality Rate ◽  
Pneumococcal Disease ◽  
Demographic Data ◽  
Case Fatality ◽  
Risk Groups ◽  
Significant Decline ◽  
Fatality Rate ◽  
North East ◽  
Increased Risk

AbstractDeclining mortality following invasive pneumococcal disease (IPD) has been observed concurrent with a reduced incidence due to effective pneumococcal conjugate vaccines. However, with IPD now increasing due to serotype replacement, we undertook a statistical analysis to estimate the trend in all-cause 30-day case fatality rate (CFR) in the North East of England (NEE) following IPD. Clinical, microbiological and demographic data were obtained for all laboratory-confirmed IPD cases (April 2006–March 2016) and the adjusted association between CFR and epidemiological year estimated using logistic regression. Of the 2510 episodes of IPD included in the analysis, 486 died within 30 days of IPD (CFR 19%). Increasing age, male sex, a diagnosis of septicaemia, being in ⩾1 clinical risk groups, alcohol abuse and individual serotypes were independently associated with increased CFR. A significant decline in CFR over time was observed following adjustment for these significant predictors (adjusted odds ratio 0.93, 95% confidence interval 0.89–0.98; P = 0.003). A small but significant decline in 30-day all-cause CFR following IPD has been observed in the NEE. Nonetheless, certain population groups remain at increased risk of dying following IPD. Despite the introduction of effective vaccines, further strategies to reduce the ongoing burden of mortality from IPD are needed.

scholarly journals Age-Dependent Serotype-Associated Case-Fatality Rate in Invasive Pneumococcal Disease in the Autonomous Community of Madrid between 2007 and 2020

2021 ◽  
Vol 9 (11) ◽  
pp. 2286
Author(s):  
Sara De Miguel ◽  
Pello Latasa ◽  
José Yuste ◽  
Luis García ◽  
María Ordobás ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Case Fatality Rate ◽  
Pneumococcal Disease ◽  
Case Fatality ◽  
Fatality Rate ◽  
Incidence And Mortality ◽  
High Incidence ◽  
Common Serotypes ◽  
Low Levels ◽  
Quellung Reaction

The aim of this study was to investigate the serotype-associated fatality rate in cases of invasive pneumococcal disease (IPD) in the Spanish region of Madrid between 2007 and 2020. Serotyping was performed by Pneumotest Latex and the Quellung reaction using commercial antisera. Case-fatality rate was estimated as the ratio between the number of deaths at hospital discharge and the number of cases attributable to each serotype. To evaluate the association measures, the odds ratios with a 95% confidence interval were calculated. Twenty five pneumococcal serotypes were associated to mortality and comprised 87.8% of the total number of isolates characterized. Serotypes 8, 3, 19A, 1, 7F, 22F, 12F, and 11A were the most prevalent (≥3% each). Serotypes 31, 11A, and 19F were significantly associated to high case-fatality rates (>20% each). The lower significantly associated case-fatality rate (<10% each) was found in serotypes 5, 1, 12B, 7F, 12F, 8, 33, and 10A. The serotypes with higher mortality levels (≥0.04 per 100,000 population) were 11A (fatality 24.0%), 3 (fatality 18.7%), 19A (fatality 12.5%), and 8 (fatality 7.2%). Serotype 3 was worrisome because it is associated with important fatality levels combined with very high incidence and mortality rates. Serotype 11A also showed a high fatality with marked incidence and mortality levels. Some few frequent serotypes as 31, 19F, and 15A despite its high fatality had low levels of mortality. By contrast other serotypes as 8 showing low fatality had high mortality ranges because it shows a wide extended distribution. Finally, common serotypes, such as 1 and 5, presented small mortality length, due to their low case-fatality rates.

scholarly journals Invasive pneumococcal disease in hospitalised children from Lima, Peru before and after introduction of the 7-valent conjugated vaccine

2019 ◽  
Vol 147 ◽  
Author(s):  
A. Luna-Muschi ◽  
F. Castillo-Tokumori ◽  
M. P. Deza ◽  
E. H. Mercado ◽  
M. Egoavil ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Case Fatality Rate ◽  
Pneumococcal Disease ◽  
Case Fatality ◽  
Fatality Rate ◽  
Erythromycin Resistance ◽  
National Immunisation ◽  
National Immunisation Program ◽  
Before And After ◽  
Sterile Site

AbstractThe objective of this study was to determine the serotype distribution and antibiotic resistance of invasive pneumococcal disease (IPD) strains in children from Lima, Peru, before and after the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7), which was introduced in the national immunisation program on 2009. We conducted a prospective, multicentre, passive surveillance IPD study during 2006–2008 and 2009–2011, before and right after the introduction of PCV7 in Peru. The study was performed in 11 hospitals and five private laboratories in Lima, Peru, in patients <18 years old, with sterile site cultures yielding Streptococcus pneumoniae. In total 159 S. pneumoniae isolates were recovered. There was a decrease in the incidence of IPD in children <2 years old after the introduction of PCV7 (18.4/100 000 vs. 5.1/100 000, P = 0.004). Meningitis cases decreased significantly in the second period (P = 0.036) as well as the overall case fatality rate (P = 0.025), including a decreased case fatality rate of pneumonia (16.3% to 0%, P = 0.04). PCV7 serotypes showed a downward trend. Vaccine-preventable serotypes caused 78.9% of IPD cases, mainly 14, 6B, 5, 19F and 23F. A non-significant increase in erythromycin resistance was reported. Our findings suggest that the introduction of PCV7 led to a significant decrease of IPD in children under 2 years old and in the overall case fatality rate.

scholarly journals 295. Is Herd Immunity from Pneumococcal Conjugate Vaccines Changing the Clinical Features of Invasive Pneumococcal Disease in Adults?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S146-S147
Author(s):  
Allison McGeer ◽  
Agron Plevneshi ◽  
Kazi Hassan
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Herd Immunity ◽  
Panel Member ◽  
Case Fatality ◽  
Population Based ◽  
Review Panel ◽  
Bacteremic Pneumonia ◽  
Study Laboratory ◽  
Research Grant

Abstract Background Numerous factors that affect the presentation and severity of pneumococcal disease. Several studies in the pre-PCV era demonstrated that organism characteristics, including serotype, are associated with variability in disease presentation and severity. We undertook an analysis of population based surveillance for invasive pneumococcal disease (IPD) to assess whether herd immunity from PCVs will change the presentation and severity of IPD in adults Methods TIBDN has performed population-based surveillance for IPD in Toronto and Peel region (pop’n 4.5M) since 1995. All sterile site isolates of S. pneumoniae are reported to a central study laboratory, isolates are serotyped, and clinical and vaccination data are collected via patient and physician interview and chart review. Population data are obtained from Statistics Canada. Backwards stepwise logistic regression assessed patient characteristics, illness features, and isolate factors associated with clinical presentation and case fatality. Results Between 1995 and 2018, 8815 episodes of IPD were identified in adults. Patients infected with PCV10not7 serotypes were younger, more likely male and without underlying illness. Patients with infections due to non-vaccine types were more likely to be immunocompromised. Case fatality in IPD declined from 177/754 in 1995/6 to 113/554 in 2017/8; OR 0.67, 95%CI0.51-0.86, P&lt; .0001) and in all serotype groups (Figure). In multivariable models adjusted for host factors, relative to infections caused PCV7 serotypes, those caused by PCV10not7 were less likely to be fatal (OR 0.65, 95%CI 0.46–0.91); those caused by PCV13not10 were more likely to be fatal (OR 1.6, 95%CI 1.3–1.9). Bacteremic pneumonia as a proportion of presentations is highest in IPD due to PCV10not7 and PCV13not10 serotypes (85% and 83%, respectively), and lowest in IPD due to non-vaccine serotypes and PCV20not15 (59% and 68%, P&lt; .0001). Meningitis is least common in IPD due to PCV10not7 serotypes (2.6%), and highest in cases due to non-vaccine types and PCV20not15 (9.0% and 8.0%, respectively, P&lt; .0001). FIgure Conclusion In our population, herd immunity from PCVs will result in a higher proportion of adult IPD occurring in immunocompromised cases, and a shift from bacteremic pneumonia to bacteremia without focus and meningitis. Disclosures Allison McGeer, MD, FRCPC, GlaxoSmithKline (Advisor or Review Panel member, Research Grant or Support)Merck (Advisor or Review Panel member, Research Grant or Support)Pfizer (Research Grant or Support)

scholarly journals Managing older adults’ fear of coronavirus disease: A new role for social work practice

2020 ◽  
pp. 147332502097329
Author(s):  
Hamed Mortazavi
Keyword(s):  
Older Adults ◽  
Case Fatality Rate ◽  
Severe Disease ◽  
Case Fatality ◽  
Social Work Practice ◽  
World Health ◽  
National Committee ◽  
Fatality Rate ◽  
Number Of Patients ◽  
Incidence And Mortality

As the number of patients infected with the 2019 novel coronavirus disease (nCOVID-19) increases, the number of deaths has also been increasing. According to World Health Organization (WHO), as of 4 October 2020, 34,804,348 cases had tested positive for nCOVID-19 globally, which among them, 1,030,738 confirmed deaths had occurred, equivalent to a case-fatality rate of 2.96%. However, in comparison with global statistics, the incidence and mortality of the nCOVID-19 infection are higher in Iran. As reported by the National Committee on COVID-19 Epidemiology of Ministry of Health of Iran, the total number of patients with confirmed COVID-19 infection has reached 468,119, of which 26,746 have died, equivalent to a case-fatality rate of 5.71%. Currently, there is solid evidence that older adults are at a higher risk of severe disease following infection from COVID-19.

Epidemiological trends of spine and spinal cord injuries in the largest Canadian adult trauma center from 1986 to 2006

2010 ◽  
Vol 12 (2) ◽  
pp. 131-140 ◽  
Author(s):  
Farhad Pirouzmand
Keyword(s):  
Spinal Cord ◽  
Trauma Center ◽  
Case Fatality Rate ◽  
Spinal Cord Injuries ◽  
Head Injuries ◽  
Case Fatality ◽  
Trauma Patients ◽  
Relative Distribution ◽  
Fatality Rate ◽  
Over Time

Object In this study the author documents the epidemiology of spine and spinal cord injuries (SCIs) over 2 decades at the largest Level I adult trauma center in Canada. He describes the current state of spine injuries (SIs), their changing patterns over the years, and the relative distribution of different demographic factors in a defined group of trauma patients. Methods Data on all trauma patients admitted to Sunnybrook Health Sciences Centre between 1986 and 2006 were collected from the Sunnybrook Trauma Registry Database. Aggregate data on SIs and SCIs, including demographic information, etiology, severity of injuries (injury severity score [ISS]), and associated injuries, were recorded. The data were analyzed in a main category of spinal fracture and/or dislocation with or without SI and in two subgroups of patients with SIs, one encompassing all forms of SCIs and the other including only complete SCIs (CSCIs). Collected data were evaluated using univariate techniques to depict the trend of variables over the years. The number of deaths per year and the length of stay (LOS) were used as crude measures of outcome. Several multivariate analysis techniques, including Poisson regression, were used to model the frequency of death and LOS as functions of various trauma variables. Results There were 12,192 trauma patients in the study period with 23.2% having SIs, 5.4% having SCIs, and 3% having CSCIs. The SCIs constituted 23.3% of all SIs. The respective characteristics of the SI, SCI, and CSCI groups were as follows: median age 36, 33, and 30 years; median LOS 18, 27, and 29 days; median ISS 29, 30, and 34; female sex ratio 34, 24, and 23%; and case fatality rate 16.7, 16.6, and 21%. Seventy-nine percent of patients had associated head injuries; conversely, 24% of patients with head injuries had SIs. The mean admission age of patients increased by ~ 10 years over the study period, from the early 30s to the early 40s. The relative incidence of SIs remained stable at ~ 23%, but the incidence of SCIs decreased ~ 40% over time to 4.5%. Motor vehicle accidents remained the principal etiology of trauma, although falling and violence became more frequent contributors of SIs. The average annual ISS remained stable over time, but the LOS was reduced by 50% in both the SI and SCI groups. Age, ISS, and SCIs were associated with a longer LOS. The case fatality rate remained relatively unchanged over time. Poisson analysis suggested that the presence of an SCI does not change the case fatality rate. Conclusions Data in this analysis will provide useful information to guide future studies on changing SI patterns, possible etiologies, and efficient resource allocation for the management of these diseases.

scholarly journals Pediatric Stroke Rates Over 17 Years: Report From a Population-Based Study

2018 ◽  
Vol 33 (7) ◽  
pp. 463-467 ◽  
Author(s):  
Laura L. Lehman ◽  
Jane C. Khoury ◽  
J. Michael Taylor ◽  
Samrat Yeramaneni ◽  
Heidi Sucharew ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Pediatric Stroke ◽  
Stroke Rate ◽  
Fatality Rate ◽  
Population Based Study ◽  
Study Region ◽  
Stroke Study ◽  
Stroke Type

We previously published rates of pediatric stroke using our population-based Greater Cincinnati Northern Kentucky Stroke Study (GCNK) for periods July 1993–June 1994 and 1999. We report population-based rates from 2 additional study periods: 2005 and 2010. We identified all pediatric strokes for residents of the GCNK region that occurred in July 1, 1993–June 30, 1994, and calendar years 1999, 2005, and 2010. Stroke cases were ascertained by screening discharge ICD-9 codes, and verified by a physician. Pediatric stroke was defined as stroke in those <20 years of age. Stroke rates by study period, overall, by age and by race, were calculated. Eleven children died within 30 days, yielding an all-cause case fatality rate of 15.7% (95% confidence interval 1.1%, 26.4%) with 3 (27.3%) ischemic, 6 (54.5%) hemorrhagic, and 2 (18.2%) unknown stroke type. The pediatric stroke rate of 4.4 per 100 000 in the GCNK study region has not changed over 17 years.

scholarly journals Pneumonia hospitalisation and case-fatality rates in older Australians with and without risk factors for pneumococcal disease: implications for vaccine policy

2019 ◽  
Vol 147 ◽  
Author(s):  
S. Dirmesropian ◽  
B. Liu ◽  
J. G. Wood ◽  
C. R. MacIntyre ◽  
P. McIntyre ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Risk Factor ◽  
Pneumococcal Disease ◽  
Large Population ◽  
Case Fatality ◽  
Population Based ◽  
Additional Risk Factor ◽  
Additional Risk ◽  
Non Invasive

AbstractCommunity-acquired pneumonia (CAP) results in substantial numbers of hospitalisations and deaths in older adults. There are known lifestyle and medical risk factors for pneumococcal disease but the magnitude of the additional risk is not well quantified in Australia. We used a large population-based prospective cohort study of older adults in the state of New South Wales (45 and Up Study) linked to cause-specific hospitalisations, disease notifications and death registrations from 2006 to 2015. We estimated the age-specific incidence of CAP hospitalisation (ICD-10 J12-18), invasive pneumococcal disease (IPD) notification and presumptive non-invasive pneumococcal CAP hospitalisation (J13 + J18.1, excluding IPD), comparing those with at least one risk factor to those with no risk factors. The hospitalised case-fatality rate (CFR) included deaths in a 30-day window after hospitalisation. Among 266 951 participants followed for 1 850 000 person-years there were 8747 first hospitalisations for CAP, 157 IPD notifications and 305 non-invasive pneumococcal CAP hospitalisations. In persons 65–84 years, 54.7% had at least one identified risk factor, increasing to 57.0% in those ⩾85 years. The incidence of CAP hospitalisation in those ⩾65 years with at least one risk factor was twofold higher than in those without risk factors, 1091/100 000 (95% confidence interval (CI) 1060–1122) compared with 522/100 000 (95% CI 501–545) and IPD in equivalent groups was almost threefold higher (18.40/100 000 (95% CI 14.61–22.87) vs. 6.82/100 000 (95% CI 4.56–9.79)). The CFR increased with age but there were limited difference by risk status, except in those aged 45 to 64 years. Adults ⩾65 years with at least one risk factor have much higher rates of CAP and IPD suggesting that additional risk factor-based vaccination strategies may be cost-effective.

scholarly journals Correlation of population mortality of COVID-19 and testing coverage: a comparison among 36 OECD countries and Taiwan

2020 ◽  
Author(s):  
Chen Wei ◽  
Chien-Chang Lee ◽  
Tzu-Chun Hsu ◽  
Wan-Ting Hsu ◽  
Chang-Chuan Chan ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Disease Burden ◽  
Case Fatality ◽  
Correlation Coefficients ◽  
Oecd Countries ◽  
Population Based ◽  
Fatality Rate ◽  
Successful Infection ◽  
Population Mortality ◽  
Testing Coverage

ABSTRACTAlthough testing is widely regarded as critical to fighting the Covid-19 pandemic, what measure and level of testing best reflects successful infection control remains unresolved. Our aim was to compare the sensitivity of two testing metrics-population testing number and testing coverage-to population mortality outcomes and identify a benchmark for testing adequacy with respect to population mortality and capture of potential disease burden. This ecological study aggregated publicly available data through April 12 on testing and outcomes related to COVID-19 across 36 OECD (Organization for Economic Development) countries and Taiwan. All OECD countries and Taiwan were included in this population-based study as a proxy for countries with highly developed economic and healthcare infrastructure. Spearman correlation coefficients were calculated between the aforementioned metrics and following outcome measures: deaths per 1 million people, case fatality rate, and case proportion of critical illness. Fractional polynomials were used to generate scatter plots to model the relationship between the testing metrics and outcomes. Testing coverage, but not population testing number, was highly correlated with population mortality (rs= −0.79, P=5.975e-09 vs rs = − 0.3, P=0.05) and case fatality rate (rs= −0.67, P=9.067e-06 vs rs= −0.21, P=0.20). A testing coverage threshold of 15-45 signified adequate testing: below 15, testing coverage was associated with exponentially increasing population mortality, whereas above 45, increased testing did not yield significant incremental mortality benefit. Testing coverage was better than population testing number in explaining country performance and can be used as an early and sensitive indicator of testing adequacy and disease burden. This may be particularly useful as countries consider re-opening their economies.

scholarly journals SEIHCRD Model for COVID-19 spread scenarios, disease predictions and estimates the basic reproduction number, case fatality rate, hospital, and ICU beds requirement

2020 ◽  
Author(s):  
Avaneesh Singh ◽  
Manish Kumar Bajpai
Keyword(s):  
Basic Reproduction Number ◽  
Case Fatality Rate ◽  
Reproduction Number ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
Hospital Beds ◽  
The Impact ◽  
Over Time ◽  
The Basic Reproduction Number

We have proposed a new mathematical method, SEIHCRD-Model that is an extension of the SEIR-Model adding hospitalized and critical twocompartments. SEIHCRD model has seven compartments: susceptible (S), exposed (E), infected (I), hospitalized (H), critical (C), recovered (R), and deceased or death (D), collectively termed SEIHCRD. We have studied COVID- 19 cases of six countries, where the impact of this disease in the highest are Brazil, India, Italy, Spain, the United Kingdom, and the United States. SEIHCRD model is estimating COVID-19 spread and forecasting under uncertainties, constrained by various observed data in the present manuscript. We have first collected the data for a specific period, then fit the model for death cases, got the values of some parameters from it, and then estimate the basic reproduction number over time, which is nearly equal to real data, infection rate, and recovery rate of COVID-19. We also compute the case fatality rate over time of COVID-19 most affected countries. SEIHCRD model computes two types of Case fatality rate one is CFR daily and the second one is total CFR. We analyze the spread and endpoint of COVID-19 based on these estimates. SEIHCRD model is time-dependent hence we estimate the date and magnitude of peaks of corresponding to the number of exposed cases, infected cases, hospitalized cases, critical cases, and the number of deceased cases of COVID-19 over time. SEIHCRD model has incorporated the social distancing parameter, different age groups analysis, number of ICU beds, number of hospital beds, and estimation of how much hospital beds and ICU beds are required in near future.

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