Rates of pneumonia among children and adults with chronic medical conditions in Germany

• Published in: BMC infectious diseases 2015-10, Vol.15 (469), p.470-470, Article 470
• Main Authors: Pelton, Stephen I, Shea, Kimberly M, Farkouh, Raymond A, Strutton, David R, Braun, Sebastian, Jacob, Christian, Klok, Rogier, Gruen, Elana S, Weycker, Derek
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Bacterial pneumonia; Child; Child, Preschool; Chronic Disease; Chronic diseases; Cohort Studies; Complications and side effects; Demographic aspects; Female; Germany - epidemiology; Humans; Immunization; Infant; Infectious diseases; Insurance Claim Reporting; Male; Middle Aged; Pneumococcal Vaccines - immunology; Pneumonia; Pneumonia - epidemiology; Pneumonia - immunology; Pneumonia - prevention & control; Retrospective Studies; Risk; Risk factors; Vaccination; Vaccines; Vaccines, Conjugate - immunology; Young Adult
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-015-1162-y

The objective of this study is to evaluate rates of all-cause pneumonia among "at-risk" and "high-risk" children and adults in Germany-in comparison with age-stratified healthy counterparts-during the period following the 2006 recommendation for universal immunization of infants with pneumococcal conjugate vaccine. Retrospective cohort design and healthcare claims information for 3.4 M persons in Germany (2009-2012) were employed. Study population was stratified by age and risk profile (healthy, "at-risk" [with chronic medical conditions], and "high-risk" [immunocompromised]). At-risk and high-risk conditions, as well as episodes of all-cause pneumonia, were identified via diagnosis, procedure, and drug codes. Rates of all-cause pneumonia were 1.7 (95 % CI 1.7-1.8) to 2.5 (2.4-2.5) times higher among children and adults with at-risk conditions versus healthy counterparts, and 1.8 (1.8-1.9) to 4.1 (4.0-4.2) times higher among children and adults with high-risk conditions. Rates of all-cause pneumonia among at-risk persons increased in a graded and monotonic fashion with increasing numbers of conditions (i.e., risk stacking). An increased risk for all-cause pneumonia in German children and adults with a spectrum of medical conditions persists in the era of widespread pneumococcal vaccination, and pneumonia risk in persons with ≥2 at-risk conditions is comparable or higher than those with high-risk conditions.