Impact of the 2009 Influenza Pandemic on Pneumococcal Pneumonia Hospitalizations in the United States
Impact of the 2009 Influenza Pandemic on Pneumococcal Pneumonia Hospitalizations in the United States
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DOI：
10.1093/infdis/jir749
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发表时间：
2012-02-01
影响因子：
6.4
通讯作者：
Viboud, Cecile
中科院分区：
文献类型：
--
作者：
Weinberger, Daniel M.;Simonsen, Lone;Viboud, Cecile
背景。感染流感病毒会增加患肺炎球菌病的风险。2009年秋季的甲型H1N1流感大流行为评估这种关系提供了一个独特的机会。感染流感病毒会增加患肺炎球菌病的风险。2009年秋季的甲型H1N1流感大流行为评估这种关系提供了一个独特的机会。利用2003-2009年美国州医疗成本和利用项目住院患者数据库中每周年龄、州和特定原因的住院情况，我们量化了流感大流行期间肺炎球菌肺炎住院率高于季节性基线的增加情况。我们发现，从2009年8月下旬到12月中旬，肺炎球菌住院人数显著增加，这与流感大流行活动最高的时间相对应。肺炎球菌疾病基线水平较低的5-19岁人群肺炎球菌住院率的相对增幅最大（比值为1.6[95%可信区间{CI}， 1.4-1.7]），而40-64岁人群肺炎球菌住院率的绝对增幅最大。相比之下，老年人没有出现过多的疾病。肺炎球菌过量住院时间的地理差异与秋季流感大流行波的地理模式相匹配。2009年流感大流行对肺炎球菌肺炎住院率产生了重大影响，这种影响的程度因年龄组和州而异，反映了观察到的流感活动的差异。
Background. Infection with influenza virus increases the risk for developing pneumococcal disease. The A/H1N1 influenza pandemic in autumn 2009 provided a unique opportunity to evaluate this relationship.Background. Infection with influenza virus increases the risk for developing pneumococcal disease. The A/H1N1 influenza pandemic in autumn 2009 provided a unique opportunity to evaluate this relationship.Methods. Using weekly age-, state-, and cause-specific hospitalizations from the US State Inpatient Databases of the Healthcare Cost and Utilization Project 2003-2009, we quantified the increase in pneumococcal pneumonia hospitalization rates above a seasonal baseline during the pandemic period.Results. We found a significant increase in pneumococcal hospitalizations from late August to mid-December 2009, which corresponded to the timing of highest pandemic influenza activity. Individuals aged 5-19 years, who have a low baseline level of pneumococcal disease, experienced the largest relative increase in pneumococcal hospitalizations (ratio, 1.6 [95% confidence interval {CI}, 1.4-1.7]), whereas the largest absolute increase was observed among individuals aged 40-64 years. In contrast, there was no excess disease in the elderly. Geographical variation in the timing of excess pneumococcal hospitalizations matched geographical patterns for the fall pandemic influenza wave.Conclusions. The 2009 influenza pandemic had a significant impact on the rate of pneumococcal pneumonia hospitalizations, with the magnitude of this effect varying between age groups and states, mirroring observed variations in influenza activity.