| Abstract | Invazivna pneumokokna bolest (IPB) definira se kao infekcija uzrokovana bakterijom Streptococcus pneumoniae koja je dokazana u primarno sterilnom materijalu. Odgovorna je za nemali morbiditet i mortalitet u odraslih i u djece te predstavlja veliki javnozdravstveni problem, osobito u populaciji koja nije obuhvaćena programom obvezog cijepljenja protiv pneumokoka. Cilj istraživanja bio je istražiti epidemiološke i kliničke osobitosti IPB u odraslih bolesnika. Retrospektivno su analizirani podaci bolesnika liječenih u Klinici za infektivne bolesti „Dr. Fran Mihaljević“ u Zagrebu tijekom 2010.─2013. godine u kojih je bolest potvrđena dokazom Streptococcus pneumoniae iz primarno sterilnih uzoraka. Obrada podataka napravljena je u paketu Statistical Package for Social Sciences (SPSS), verzija 20.0 (IBM corporation, Armonk, NY, USA). Tijekom ispitivanog četverogodišnjeg razdoblja hospitalizirano je 130 bolesnika s IPB od čega je bakterijemiju/sepsu imalo 11 (8,4%), meningitis 43 (33,1%), a pneumoniju 76 (58,5%) bolesnika. Dobnoj skupini 18─64 godine pripadalo je 56,9% bolesnika. Jedan od čimbenika rizika za razvoj IPB imalo je 67,7% bolesnika, a najčešći su bili alkoholizam (26,9%), pušenje (24,6%), maligna bolest (18,4%), šećerna bolest (18.4%) te kronična bolest kardiovaskularnog sustava (16,9%). Ukupna smrtnost od IPB iznosila je 16,9%, a u bolesnika s meningitisom 13,9%, s pneumonijom 17,1%, a s bakterijemijom/sepsom 27,3%. Smrtnost u bolesnika dobi ≥75 godina iznosila je 29,4%, a ≥85 godina čak 75%. Obzirom da su među kliničkim izolatima u naših bolesnika dominirali serotipovi sadržani u cjepivima PCV13 (82,1%) i PPSV23 (94%), možemo zaključiti kako bi uvođenje obveznog cijepljenja odrasle populacije pridonijelo smanjenju morbiditeta i mortaliteta od IPB. |
| Abstract (english) | Invasive pneumococcal disease (IPD) is defined as an infection caused by Streptococcus pneumoniae that is detected in primarily sterile material. It is responsible for high morbidity and mortality in adults and children and continues to be an important public health issue, especially among population not covered by mandatory pneumococcal immunisation program. The aim was to investigate the epidemiological and clinical characteristics of IPD in adults. We retrospectively analyzed medical history data of patients treated at the University Hospital for Infectious Diseases in Zagreb in the period 2010─2013, in whom the disease was confirmed by detection of Streptococcus pneumoniae from primarily sterile samples. Data analysis was performed using the Statistical Package for Social Sciences (SPSS), version 20.0 (IBM corporation, Armonk, NY, USA). During the analyzed period, a total of 130 patients with IPD were hospitalized, 11 (8.4%) of whom had bacteremia/sepsis, 43 (33.1%) meningitis, and 76 (58.5%) pneumonia. A total of 56.9% patients belonged to the age group 18─64 years. A total of 67.7% patients had one risk factor for development of IPD, the most frequent being: alcoholism (26.9%), smoking (24.6%), malignant disease (18.4%), diabetes mellitus (18.4%), and chronic cardiovascular disease (16.9%). The overall IPD mortality was 16.9%, in patients with meningitis 13.9%, in those with pneumonia 17.1%, and in patients with bacteremia/sepsis 27.3%. The mortality in patients ≥75 years was 29.4%, and in those ≥85 years even 75%. Given that serotypes contained in vaccines PCV13 (82.1%) and PPSV23 (94%) dominated among the clinical isolates, we can conclude that the introduction of mandatory pneumococcal vaccination among adult population would contribute to decreasing the morbidity and mortality from IPD.
Keywords: invasive pneumococcal disease, sepsis, meningitis, pneumonia |
