Pneumococcal serotypes and mortality following invasive pneumococcal disease: a population-based cohort study.

• Main Authors: Zitta B Harboe, Reimar W Thomsen, Anders Riis, Palle Valentiner-Branth, Jens Jørgen Christensen, Lotte Lambertsen, Karen A Krogfelt, Helle B Konradsen, Thomas L Benfield
• Format: Article
• Language: English
• Published: Public Library of Science (PLoS) 2009-05-01
• Series: PLoS Medicine
• Online Access: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19468297/pdf/?tool=EBI

<h4>Background</h4>Pneumococcal disease is a leading cause of morbidity and mortality worldwide. The aim of this study was to investigate the association between specific pneumococcal serotypes and mortality from invasive pneumococcal disease (IPD).<h4>Methods and findings</h4>In a nationwide population-based cohort study of IPD in Denmark during 1977-2007, 30-d mortality associated with pneumococcal serotypes was examined by multivariate logistic regression analysis after controlling for potential confounders. A total of 18,858 IPD patients were included. Overall 30-d mortality was 18%, and 3% in children younger than age 5 y. Age, male sex, meningitis, high comorbidity level, alcoholism, and early decade of diagnosis were significantly associated with mortality. Among individuals aged 5 y and older, serotypes 31, 11A, 35F, 17F, 3, 16F, 19F, 15B, and 10A were associated with highly increased mortality as compared with serotype 1 (all: adjusted odds ratio >or=3, p<0.001). In children younger than 5 y, associations between serotypes and mortality were different than in adults but statistical precision was limited because of low overall childhood-related mortality.<h4>Conclusions</h4>Specific pneumococcal serotypes strongly and independently affect IPD associated mortality.