Risk of invasive pneumococcal infections among working age adults with asthma. Issue 8 (4th August 2010)

• Record Type: Journal Article
• Authors: Klemets, Peter; Lyytikäinen, Outi; Ruutu, Petri; Ollgren, Jukka; Kaijalainen, Tarja; Leinonen, Maija; Pekka Nuorti, J
• Is Part Of: Thorax. Volume 65:Issue 8(2010)
• Page Start: 698
• Page End: 702
• Publication Date: 2010-08-04
• Subjects: Asthma -- COPD -- Streptococcus pneumoniae -- risk factors -- pneumococcal vaccines -- bacterial infection -- infection control; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thx.2009.132670
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Background: Information about the risk of invasive pneumococcal infection (IPI) among adults with asthma is limited and inconsistent. To evaluate this association, a population-based case–control study was conducted. Methods: Cases of IPI ( Streptococcus pneumoniae isolated from blood or cerebrospinal fluid) were identified through national, population-based laboratory surveillance during 1995–2002. To maximise exclusion of chronic obstructive pulmonary disease, the analysis was limited to patients aged 18–49 years and 10 selected age-, sex- and health district-matched controls for each case from the Population Information System. Information on underlying medical conditions was obtained through linking surveillance data to other national health registries. Asthma requiring ≥1 hospitalisation in the past 12 months was defined as high risk asthma (HRA); low risk asthma (LRA) was defined as entitlement to prescription drug benefits and no hospitalisation for asthma in the past 12 months. Results: 1282 patients with IPI and 12 785 control subjects were identified. Overall, 7.1% of cases and 2.5% of controls had asthma (6.0% and 2.4% had LRA whereas 1.1% and 0.1% had HRA, respectively. After adjustment for other independent risk factors in a conditional logistic regression model, IPI was associated with both LRA (matched OR (mOR) 2.8; 95% CI 2.1 to 3.6) and HRA (mOR, 12.3; 95% CI 5.4 to 28.0). The adjusted population-attributable risk was 0.039 (95% CI 0.023 to 0.055) for LRA and 0.01 (95% CI 0.0035 to 0.017) for HRA. Conclusions: Working age adults with asthma are at increased risk of IPI. In this population, ∼5% of disease burden could be attributed to asthma. These findings support adding medicated asthma in adults to the list of indications for pneumococcal vaccination.