A pneumococcal vaccination in immunocompromised patients is needed

Objectives:
Invasive pneumococcal disease (IPD) is associated with high morbidity and mortality, with immunocompromised patients (ICPs) at particular risk. Therefore, guidelines recommend pneumococcal vaccination for these patients. However, guidelines are scarcely underpinned with references to incidence studies of IPD in this population. This, potentially results in unawareness of the importance of vaccination and low vaccination rates. Therefore, this review article has been conducted.

Should immunocompromised patients be vaccinated?

Study design:
This review article included 38 studies, reporting an incidence or rate of invasive pneumococcal disease, defined as isolation of Streptococcus pneumoniae from a normally sterile site.

Results and conclusions:
The investigators found random effects meta-analysis of 38 studies showed a pooled invasive pneumococcal disease incidence of:
-331/100,000 person years in patients with HIV in the late-antiretroviral treatment era in non-African countries;
-318/100,000 in African countries;
-696 and 812/100,000 in patients who underwent an autologous or allogeneic stem cell transplantation, respectively;
-465/100,000 in patients with a solid organ transplantation;
-65/100,000 in patients with chronic inflammatory diseases and;
-10/100,000 in healthy control cohorts.

The investigators concluded that immunocompromised patients are at increased risk of contracting invasive pneumococcal disease, especially those with HIV and those who underwent transplantation. These findings support the relevance of pneumococcal vaccination in immunocompromised patients.

Original title:
Incidence of invasive pneumococcal disease in immunocompromised patients: A systematic review and meta-analysis by van Aalst M, Lötsch F, [...], de Bree GJ.

Link:
https://www.travelmedicinejournal.com/article/S1477-8939(18)30111-X/fulltext

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and study design/meta-analysis/significant right here.

An immunocompromised host is a patient who has not the ability to respond normally to an infection due to an impaired or weakened immune system. This inability to fight infection can be caused by a number of conditions, including illness and disease (eg, diabetes, HIV), malnutrition and drugs.