TY - JOUR
T1 - Serogroup-specific epidemiology of Streptococcus pneumoniae
T2 - Associations with age, sex, and geography in 7,000 episodes of invasive disease
AU - Scott, J. A.G.
AU - Hall, A. J.
AU - Dagan, R.
AU - Dixon, J. M.S.
AU - Eykyn, S. J.
AU - Fenoll, A.
AU - Hortal, M.
AU - Jette, L. P.
AU - Jorgensen, J. H.
AU - Lamothe, F.
AU - Latorre, C.
AU - Macfarlane, J. T.
AU - Shlaes, D. M.
AU - Smart, L. E.
AU - Taunay, A.
N1 - Funding Information:
Received 25 August 1995; revised 2 January 1996. Financial support: Dr. Scott is supported by the Wellcome Trust of Great Britain through a research training fellowship in clinical epidemiology (no. 035375). Reprints or correspondence: Dr. J. Anthony G. Scott, Wellcome Trust/ KEMRI-CRC, Kilifi Research Unit, P.O. Box 230, Kilifi, Kenya.
PY - 1996
Y1 - 1996
N2 - A study sample of 7,010 episodes of invasive Streptococcus pneumoniae disease was obtained by combining 13 existing datasets. Disease episodes due to each of 12 pneumococcal serogroups (1, 3-9, 14, 18, 19, and 23) were then compared with episodes in a constant internal control group to describe serogroup-specific variations in disease frequency by age, sex, and geographic origin. The results are presented as odds ratios (with 95% confidence intervals) derived by logistic regression, with adjustment for the major confounders, including dataset of origin. Variation in the male:female ratios between serogroups is small, suggesting that capsular characteristics are an unlikely explanation for the male preference of S. pneumoniae. Serogroups associated with higher nasopharyngeal prevalence (e.g., 19 and 23) are relatively more common in Europe and North America, while the invasive serotypes 1 and 5 are much more common in South America. The custom of reporting serogroup frequencies in two age groups, children and adults, conceals much of the variation in the age distributions across the whole span of life. The reduction of risk associated with serogroups 6, 14, 18, 19, and 23 beyond childhood follows different gradients, being most abrupt in serotype 14 and most gradual in serogroup 18. The relative risk of disease with serotype 1 declines steadily throughout life, while with serotypes 3 and 8 it increases over middle age. Serogroups 7 and 23 are found unusually frequently in the third decade of life. Because of the wide differences in the epidemiology of individual serogroups of S. pneumoniae, it is questionable whether pneumococcal infection should continue to be classified as a single disease entity.
AB - A study sample of 7,010 episodes of invasive Streptococcus pneumoniae disease was obtained by combining 13 existing datasets. Disease episodes due to each of 12 pneumococcal serogroups (1, 3-9, 14, 18, 19, and 23) were then compared with episodes in a constant internal control group to describe serogroup-specific variations in disease frequency by age, sex, and geographic origin. The results are presented as odds ratios (with 95% confidence intervals) derived by logistic regression, with adjustment for the major confounders, including dataset of origin. Variation in the male:female ratios between serogroups is small, suggesting that capsular characteristics are an unlikely explanation for the male preference of S. pneumoniae. Serogroups associated with higher nasopharyngeal prevalence (e.g., 19 and 23) are relatively more common in Europe and North America, while the invasive serotypes 1 and 5 are much more common in South America. The custom of reporting serogroup frequencies in two age groups, children and adults, conceals much of the variation in the age distributions across the whole span of life. The reduction of risk associated with serogroups 6, 14, 18, 19, and 23 beyond childhood follows different gradients, being most abrupt in serotype 14 and most gradual in serogroup 18. The relative risk of disease with serotype 1 declines steadily throughout life, while with serotypes 3 and 8 it increases over middle age. Serogroups 7 and 23 are found unusually frequently in the third decade of life. Because of the wide differences in the epidemiology of individual serogroups of S. pneumoniae, it is questionable whether pneumococcal infection should continue to be classified as a single disease entity.
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U2 - 10.1093/clinids/22.6.973
DO - 10.1093/clinids/22.6.973
M3 - Article
C2 - 8783696
AN - SCOPUS:0029783747
VL - 22
SP - 973
EP - 981
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 6
ER -