| Abstract | Uvod: Invazivna pneumokokna bolest (IPB) teži je oblik bolesti uzrokovane bakterijom Streptococcus pneumoniae koja se može dokazati u primarno sterilnim uzorcima. U općoj populaciji IPB značajno doprinosi morbiditetu i mortalitetu, osobito u djece, osoba dobi ≥ 65 godina te imunokompromitiranih zbog čega predstavlja značajan javnozdravstveni problem. Uspješan način sprječavanja IPB je cijepljenje.
Ispitanici i metode: Provedeno je retrospektivno istraživanje u odraslih bolesnika hospitaliziranih zbog IPB na području Grada Zagreba i Zagrebačke županije. Obuhvaćeno je razdoblje od 1. siječnja 2010. do 31. prosinca 2022. godine.
Rezultati: Tijekom ispitivanog razdoblja hospitalizirano je 389 bolesnika s IPB, od toga 214 (55,5 %) muškaraca. Godišnja incidencija IPB u odraslih u ispitivanom razdoblju kretala se 0,6 – 4,1/100 000 stanovnika godišnje. Čak 185 (47,6 %) ispitanika bilo je iz dobne skupine ≥ 65 godina, a čak 309 (79,4 %) ≥ 50 godina. U 331 (85,1 %) bolesnika utvrđen je ≥ 1 čimbenik rizika, a najčešći je bio dob ≥ 65 godina. Najčešća klinička prezentacija bila je pneumonija (66,3 %), potom meningitis (20,3 %) te sepsa (13,4 %). Preživjelo je 325 (83,5 %), a umrlo 64 (16,5 %) bolesnika. Indikaciju za cijepljenje protiv pneumokokne bolesti imalo je 249 (64,0 %) bolesnika, ali je samo 11 (4,4 %) bolesnika bilo cijepljeno. Serotip pneumokoka je određen u 233 (59,9 %) izolata. Najčešći serotip bio je serotip 3 koji je dokazan u 49/233 (21 %) bolesnika. Od potvrđenih serotipova, 180 (77,3 %) pripada serotipovima koji su uključeni u PCV13 cjepivo, 208 (89,3 %) serotipovima uključenim u PCV20 cjepivo, a 212 (91,0 %) serotipovima uključenim u PPSV23 cjepivo.
Zaključak: Uvođenje cijepljenja protiv pneumokokne bolesti dovelo je do pada incidencije i mortaliteta od invazivne pneumokokne bolest u odraslih. U cilju postizanja daljnjeg pada morbiditeta i mortaliteta od IPB potrebno je povećati cijepni obuhvat u odraslih, osobito u osoba s čimbenicima rizika. |
| Abstract (english) | Background: Invasive pneumococcal disease (IPD) is a severe form of illness caused by the bacterium Streptococcus pneumoniae, which can be detected in primarily sterile samples. IPD significantly contributes to morbidity and mortality in the general population, particularly in children, individuals ≥ 65 years of age, and immunocompromised, making it a significant public health concern. Vaccination is a successful way to prevent IPD.
Material and methods: A retrospective study was conducted on adult patients hospitalized due to IPD in the City of Zagreb and Zagreb County. The study period spanned from January 1, 2010, to December 31, 2022.
Results: During the study period, 389 patients with IPD were hospitalized, of which 214 (55.5%) were male. The annual incidence of IPD in adults ranged from 0.6 to 4.1 per 100,000 population. A total of 185 (47.6%) participants were aged ≥ 65 years, and 309 (79.4%) were aged ≥ 50 years. In 331 (85.1%) patients, at least one risk factor was identified, with the most common being age ≥ 65 years. The most frequent clinical presentation was pneumonia (66.3%), followed by meningitis (20.3%) and sepsis (13.4%). Out of the total, 325 (83.5%) patients survived, while 64 (16.5%) died. Among the patients, 249 (64.0%) had an indication for pneumococcal vaccination, but only 11 (4.4%) were actually vaccinated. Pneumococcal serotype was determined in 233 (59.9%) isolates with serotype 3 being the most frequent (49/233, 21%). Of the confirmed serotypes, 180 (77.3%) belonged to serotypes included in the PCV13 vaccine, 208 (89.3%) belonged to serotypes included in the PCV20 vaccine, and 212 (91.0%) belonged to serotypes included in the PPSV23 vaccine.
Conclusion: The introduction of pneumococcal vaccination has led to a decrease in the incidence and mortality of IPD in adults. To further reduce the morbidity and mortality from IPD, it is necessary to increase vaccine coverage in adults, particularly in individuals with risk factors. |
