PDF(Pubmed)
Abstract：
UNASSIGNED: Streptococcus pneumoniae vaccination effectiveness (VE) in individuals with reduced kidney function is unknown. We estimated pneumococcal conjugate vaccine (PCV13), pneumococcal polysaccharide vaccine (PPSV23), and combined PCV13 and PPSV23 effectiveness against pneumococcal disease in individuals with and without reduced estimated glomerular filtration rate (eGFR).
UNASSIGNED: All eligible individuals (case and controls) were adults (aged ≥18 years) hospitalized within the Geisinger Health System and required to have S. pneumoniae urinary antigen testing (i.e. test-negative design). Vaccination records were obtained from the electronic health record and statewide vaccination registry. After controlling for the probability of receiving a pneumococcal vaccine, we used multivariable logistic regression models to estimate the odds ratios (ORs) of vaccination between those who did and did not meet the S. pneumoniae case definition. VE was calculated as (1 - OR) × 100%.
UNASSIGNED: There were 180 cases and 3889 controls (mean age 69 years, female 48%, white 97%, mean eGFR 71 mL/min/1.73 m2). The adjusted population PCV13 VE was 39% (95% CI 13%-58%), and combination PCV13 and PPSV23 was 39% (95% CI 12%-58%). PPSV23 VE was -3.7% (95% CI -57% to 32%). Stratified by eGFR, adjusted PCV13 VE was consistent in eGFR ≥60 [VE 38% (95% CI 2.9%-61%)] and 30-59 [VE 61% (95% CI 24%-80%)] without significant interaction. VE was not calculable for eGFR <30 due to small sample size.
UNASSIGNED: PCV13 vaccination was associated with reduced risk of S. pneumoniae hospitalization in individuals with a reduced eGFR (30-59 mL/min/1.73 m2).
UNASSIGNED: All eligible individuals (case and controls) were adults (aged ≥18 years) hospitalized within the Geisinger Health System and required to have S. pneumoniae urinary antigen testing (i.e. test-negative design). Vaccination records were obtained from the electronic health record and statewide vaccination registry. After controlling for the probability of receiving a pneumococcal vaccine, we used multivariable logistic regression models to estimate the odds ratios (ORs) of vaccination between those who did and did not meet the S. pneumoniae case definition. VE was calculated as (1 - OR) × 100%.
UNASSIGNED: There were 180 cases and 3889 controls (mean age 69 years, female 48%, white 97%, mean eGFR 71 mL/min/1.73 m2). The adjusted population PCV13 VE was 39% (95% CI 13%-58%), and combination PCV13 and PPSV23 was 39% (95% CI 12%-58%). PPSV23 VE was -3.7% (95% CI -57% to 32%). Stratified by eGFR, adjusted PCV13 VE was consistent in eGFR ≥60 [VE 38% (95% CI 2.9%-61%)] and 30-59 [VE 61% (95% CI 24%-80%)] without significant interaction. VE was not calculable for eGFR <30 due to small sample size.
UNASSIGNED: PCV13 vaccination was associated with reduced risk of S. pneumoniae hospitalization in individuals with a reduced eGFR (30-59 mL/min/1.73 m2).
摘要：
■肺炎链球菌在肾功能减退个体中的疫苗接种效果(VE)尚不清楚。我们估计肺炎球菌结合疫苗（PCV13），肺炎球菌多糖疫苗（PPSV23），以及PCV13和PPSV23对肺炎球菌疾病的联合有效性，在有或没有降低的肾小球滤过率（eGFR）的个体中。
■所有符合条件的个体（病例和对照）均为在Geisinger卫生系统住院的成年人（年龄≥18岁），需要进行肺炎链球菌尿抗原检测（即试验阴性设计）。疫苗接种记录是从电子健康记录和全州疫苗接种登记处获得的。在控制了接种肺炎球菌疫苗的概率后，我们使用多变量逻辑回归模型来估算符合肺炎链球菌病例定义的接种和不符合肺炎链球菌病例定义的接种风险比(OR).VE计算为(1-OR)×100%。
■有180例病例和3889例对照（平均年龄69岁，女性48%,白色97%,平均eGFR71mL/min/1.73m2)。调整后的人群PCV13VE为39%(95%CI13%-58%)，PCV13和PPSV23的组合为39%（95%CI12%-58%）。PPSV23VE为-3.7%（95%CI-57%至32%）。由eGFR分层，校正后的PCV13VE在eGFR≥60[VE38%(95%CI2.9%-61%)]和30-59[VE61%(95%CI24%-80%)]中一致，无显著交互作用。由于样本量小，对于eGFR<30，VE无法计算。
在eGFR降低(30-59mL/min/1.73m2)的个体中，PCV13疫苗接种与肺炎链球菌住院风险降低相关。
■所有符合条件的个体（病例和对照）均为在Geisinger卫生系统住院的成年人（年龄≥18岁），需要进行肺炎链球菌尿抗原检测（即试验阴性设计）。疫苗接种记录是从电子健康记录和全州疫苗接种登记处获得的。在控制了接种肺炎球菌疫苗的概率后，我们使用多变量逻辑回归模型来估算符合肺炎链球菌病例定义的接种和不符合肺炎链球菌病例定义的接种风险比(OR).VE计算为(1-OR)×100%。
■有180例病例和3889例对照（平均年龄69岁，女性48%,白色97%,平均eGFR71mL/min/1.73m2)。调整后的人群PCV13VE为39%(95%CI13%-58%)，PCV13和PPSV23的组合为39%（95%CI12%-58%）。PPSV23VE为-3.7%（95%CI-57%至32%）。由eGFR分层，校正后的PCV13VE在eGFR≥60[VE38%(95%CI2.9%-61%)]和30-59[VE61%(95%CI24%-80%)]中一致，无显著交互作用。由于样本量小，对于eGFR<30，VE无法计算。
在eGFR降低(30-59mL/min/1.73m2)的个体中，PCV13疫苗接种与肺炎链球菌住院风险降低相关。
