Epidemiología de la neumonía neumocócica en adultos mayores de 50 años: estudio de cohortes en Cataluña, 2017-2018

Objective: To analyse population-based incidence and lethality of pneumococcal pneumonia (PP) requiring hospitalisation among Catalonian adults after universal vaccination implementa-tion in infants.Design: Population-based cohort study.Setting: Primary care/hospital, Catalonia.Participants: 2,059,645 individuals > 50 years old affiliated to the Institut Catala de la Salut retrospectively followed between 01/01/2017 and 31/12/2018. Main outcome measures: The Catalonian information system for the development of research in primary care (SIDIAP, Sistema de Informacion para el Desarrollo de la Investigacion en Aten-cion Primaria) was used to establish baseline characteristics and risk-strata of cohort members at study start: low-risk (immunocompetent persons without risk conditions), intermediate-risk (immunocompetent persons with at-risk condition) and high-risk (immunocompromising condi-tions). PP requiring hospitalisation among cohort members across study period were collected from CMBD (Conjunto Minimo Basico de Datos) discharge data of 64 reference Catalonian hospitals.Results: An amount of 3592 episodes of HPP were observed, with an incidence density of 90.7 cases per 100,000 person-years (95% CI: 85.2-96.5), being 11.9 bacteremic (95% CI: 10.8-13.1) and 78.8 non-bacteremic (95% CI: 74.0-83.8). Incidence rates substantially increased by age (37.3 in 50-64 years vs. 98.3 in 65-79 years vs. 259.8 in >80 years) and baseline-risk stratum (42.1, 120.7 and 238.6 in low-, intermediate-and high-risk stratum, respectively). Overall case-fatality rate was 7.6% (10.8% in invasive cases vs. 7.1% in non-invasive cases; pP= .004). In multivariable analyses, high-risk stratum and oldest age were the strongest predictors for invasive and non-invasive cases, respectively.Conclusion: Incidence and lethality of PP remained moderate among adults >50 years in Cata-lonia during 2017-2018 (earlier period after universal vaccination introduction for infants).(c) 2023 The Author(s). Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).