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2717. The Impact of Pneumococcal Conjugate Vaccine in Nonbacteremic Pneumococcal Pneumonia Among Cancer Patients
BACKGROUND: Invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NB-PNA) are associated with substantial morbidity and mortality in cancer patients. IPD incidence among cancer patients at MSKCC sharply declined after the introduction of routine childhood immunization with t...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810483/ http://dx.doi.org/10.1093/ofid/ofz360.2394 |
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author | Lee, Yeon Joo Richards, Rocco Su, Yiqi Kaltsas, Anna Papanicolaou, Genovefa |
author_facet | Lee, Yeon Joo Richards, Rocco Su, Yiqi Kaltsas, Anna Papanicolaou, Genovefa |
author_sort | Lee, Yeon Joo |
collection | PubMed |
description | BACKGROUND: Invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NB-PNA) are associated with substantial morbidity and mortality in cancer patients. IPD incidence among cancer patients at MSKCC sharply declined after the introduction of routine childhood immunization with the 7-valent pneumococcal conjugate vaccine (PCV7) (1). An indirect effect of PCV on pneumococcal pneumonia incidence has also been reported (2, 3). The impact of PCV on the incidence of NB-PNA in patients with cancer has not been well studied. METHODS: Retrospective review of patients treated at MSKCC, 1993–2012. Unique patient visits (UPV) per year were defined as ≥1 inpatient or outpatient encounter within one calendar year. NB-PNA was defined as Isolation of Streptococcus pneumoniae from sputum or bronchoalveolar lavage (BAL); with associated symptoms (cough, sputum production, and/or fever) and radiographic findings compatible with pneumonia on chest radiograph or computerized chest tomography. NB-PNA incidence was calculated as number of NB-PNA cases per 1000 UPV. Three-time periods were examined: “before PCV7” (1993–2000), “after PCV7” (2001–2010), “after PCV13” (2011–2012). RESULTS: Of 323 NB-PNA cases, S. pneumoniae was isolated from BAL in 64 (20%) and sputum in 259 (80%). 182 (56%), 121 (37%), and 20 (7%) NB-PNA cases occurred “before PCV7,” “after PCV7,” and “after PCV13,” respectively. The incidence of NB-PNA was highest in patients with hematologic malignancies and in patients ≥65 years during all three periods (Table 1). NB-PNA incidence was lower “after PCV7” compared with “before PCV7” (0.47 vs. 0.13, P < 0.001). A non-statistically significant lower incidence of NB-PNA was noted “after PCV13” vs. “after PCV7” (0.13 vs. 0.09, P = 0.19). The highest decline of NB-PNA after PCV7 introduction was observed in patients ≥65 years (0.67 vs. 0.16, P < 0.001). CONCLUSION: (1) The incidence of NB-PNA in adult cancer patient declined after PCV7 compared with before PCV7. (2) The reduction in NB-PNA was highest in patients ≥65 years suggesting an indirect effect from PCV7 childhood immunization. (3) A trend toward decreased incidence in NB-PNA was noted after PCV13; further surveillance is required to ascertain this trend. [Image: see text] DISCLOSURES: All authors: No reported disclosures. |
format | Online Article Text |
id | pubmed-6810483 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-68104832019-10-28 2717. The Impact of Pneumococcal Conjugate Vaccine in Nonbacteremic Pneumococcal Pneumonia Among Cancer Patients Lee, Yeon Joo Richards, Rocco Su, Yiqi Kaltsas, Anna Papanicolaou, Genovefa Open Forum Infect Dis Abstracts BACKGROUND: Invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NB-PNA) are associated with substantial morbidity and mortality in cancer patients. IPD incidence among cancer patients at MSKCC sharply declined after the introduction of routine childhood immunization with the 7-valent pneumococcal conjugate vaccine (PCV7) (1). An indirect effect of PCV on pneumococcal pneumonia incidence has also been reported (2, 3). The impact of PCV on the incidence of NB-PNA in patients with cancer has not been well studied. METHODS: Retrospective review of patients treated at MSKCC, 1993–2012. Unique patient visits (UPV) per year were defined as ≥1 inpatient or outpatient encounter within one calendar year. NB-PNA was defined as Isolation of Streptococcus pneumoniae from sputum or bronchoalveolar lavage (BAL); with associated symptoms (cough, sputum production, and/or fever) and radiographic findings compatible with pneumonia on chest radiograph or computerized chest tomography. NB-PNA incidence was calculated as number of NB-PNA cases per 1000 UPV. Three-time periods were examined: “before PCV7” (1993–2000), “after PCV7” (2001–2010), “after PCV13” (2011–2012). RESULTS: Of 323 NB-PNA cases, S. pneumoniae was isolated from BAL in 64 (20%) and sputum in 259 (80%). 182 (56%), 121 (37%), and 20 (7%) NB-PNA cases occurred “before PCV7,” “after PCV7,” and “after PCV13,” respectively. The incidence of NB-PNA was highest in patients with hematologic malignancies and in patients ≥65 years during all three periods (Table 1). NB-PNA incidence was lower “after PCV7” compared with “before PCV7” (0.47 vs. 0.13, P < 0.001). A non-statistically significant lower incidence of NB-PNA was noted “after PCV13” vs. “after PCV7” (0.13 vs. 0.09, P = 0.19). The highest decline of NB-PNA after PCV7 introduction was observed in patients ≥65 years (0.67 vs. 0.16, P < 0.001). CONCLUSION: (1) The incidence of NB-PNA in adult cancer patient declined after PCV7 compared with before PCV7. (2) The reduction in NB-PNA was highest in patients ≥65 years suggesting an indirect effect from PCV7 childhood immunization. (3) A trend toward decreased incidence in NB-PNA was noted after PCV13; further surveillance is required to ascertain this trend. [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6810483/ http://dx.doi.org/10.1093/ofid/ofz360.2394 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Lee, Yeon Joo Richards, Rocco Su, Yiqi Kaltsas, Anna Papanicolaou, Genovefa 2717. The Impact of Pneumococcal Conjugate Vaccine in Nonbacteremic Pneumococcal Pneumonia Among Cancer Patients |
title | 2717. The Impact of Pneumococcal Conjugate Vaccine in Nonbacteremic Pneumococcal Pneumonia Among Cancer Patients |
title_full | 2717. The Impact of Pneumococcal Conjugate Vaccine in Nonbacteremic Pneumococcal Pneumonia Among Cancer Patients |
title_fullStr | 2717. The Impact of Pneumococcal Conjugate Vaccine in Nonbacteremic Pneumococcal Pneumonia Among Cancer Patients |
title_full_unstemmed | 2717. The Impact of Pneumococcal Conjugate Vaccine in Nonbacteremic Pneumococcal Pneumonia Among Cancer Patients |
title_short | 2717. The Impact of Pneumococcal Conjugate Vaccine in Nonbacteremic Pneumococcal Pneumonia Among Cancer Patients |
title_sort | 2717. the impact of pneumococcal conjugate vaccine in nonbacteremic pneumococcal pneumonia among cancer patients |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810483/ http://dx.doi.org/10.1093/ofid/ofz360.2394 |
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