Influenza vaccination is associated with reduced severity of community-acquired pneumonia
Influenza vaccination is associated with reduced severity of community-acquired pneumonia
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DOI：
10.1183/09031936.00133510
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发表时间：
2011-07-01
影响因子：
24.3
通讯作者：
Schaberg, T.
中科院分区：
文献类型：
--
作者：
Tessmer, A.;Welte, T.;Schaberg, T.
肺炎是流感相关发病率和死亡率的重要原因。流感疫苗接种已被证明可以降低流感季节的发病率和死亡率。预防严重肺炎可能有助于流感疫苗接种的有益效果。因此，我们调查了先前接种流感疫苗对社区获得性肺炎(CAP)患者疾病严重性和死亡率的影响。分析来自于由德国CAP能力网络发起的观察性多中心队列研究。患者分别作为流感季节和淡季队列进行了分析。在季节队列(2,368名患者)中，根据大多数分析参数(抑制指数和GT；=1：或0.76，95%CI为0.60-0.98；降钙素原和GT；=2.0 ng.毫升(-1)：或0.53，95%CI为0.35-0.81；降钙素原和GT；；=0.5ng.mL(-1)：或0.71，95%可信区间0.51~0.99)，6个月随访总生存率显著提高(HR 0.63，95%可信区间0.45~0.89)。在淡季队列(2,632名患者)中，接种状态对CAP的严重程度或疾病结局没有显著影响。结论是，在流感季节，先前接种流感疫苗与较轻的临床病程和改善总体长期存活率有关。
Pneumonia is an important cause of influenza-associated morbidity and mortality. Influenza vaccination has been shown to reduce morbidity and mortality during influenza seasons. Protection from severe pneumonia may contribute to the beneficial effect of influenza vaccination. Therefore, we investigated the impact of prior influenza vaccination on disease severity and mortality in patients with community-acquired pneumonia (CAP).Analysis from an observational, multicentre cohort study initiated by the German competence network for CAP was performed. Patients were analysed separately as an influenza season and off-season cohort. Associations between vaccination status and outcome parameters were evaluated by multivariate analyses.In the season cohort (2,368 patients) CAP in vaccinated patients was significantly less severe according to most analysed parameters (CURB index >= 1: OR 0.76, 95% CI 0.60-0.98; procalcitonin >= 2.0 ng.mL(-1): OR 0.53, 95% CI 0.35-0.81; procalcitonin >= 0.5 ng.mL(-1): OR 0.71, 95% CI 0.51-0.99) and these patients showed a significantly better overall survival within the 6-month follow-up period (HR 0.63, 95% CI 0.45-0.89). Within the off-season cohort (2,632 patients) there was no significant influence of vaccination status on CAP severity or disease outcome.In conclusion, prior influenza vaccination was associated with less severe clinical course and improved overall long-term survival in patients with CAP during influenza seasons.