Underlying clinical conditions and invasive pneumococcal disease (IPD) in adults in Spain (ODIN study, 2010-2012)

Background: Some underlying clinical conditions are known to increase the risk of IPD in adults. Objectives: This study aimed to explore medical conditions by age group and previous vaccination history in adults with IPD. Methods: Prospective surveillance of culture-confirmed IPDs in adults (≥18 years) performed in 9 Spanish hospitals (August 2010-June 2012). Results: 436 cases (mean age 62.7;17.4 years; 58.7% males) were included. No differences were seen in immune status or underlying diseases with respect to age (62.0;16.3 and 63.2;18.1 in immunocompromised and inmunocompetent patients, respectively; p=0.30; 63.1;16.9 and 58.7;20.7 in patients with ≥1 and without underlying conditions, respectively; p=0.18). The most frequent clinical presentation was invasive pneumonia (303; 69.5%). 19% had received polysaccharide pneumococcal vaccine (PPV). No differences were found in the outcome according to PPV vaccination history. Case fatality rate was 13.3% and 40% in severe sepsis. Table shows comorbidities by age group. ![Figure][1] Conclusions: The high frequency of IPD cases in patients with chronic respiratory disease and/or smoking supports the need for a new approach in the management of these underlying conditions. Facing limitations of PPV, vaccination with PCV13 could be a better strategy. This study was sponsored by Pfizer. [1]: pending:yes