Table of Contents Table of Contents
Previous Page  185 / 290 Next Page
Show Menu
Previous Page 185 / 290 Next Page
Page Background


This prospective study confirms the burden of HZ and the

increasing risk for developing PHN with age in German individuals


50 years.


Clinical and economic burden of pneumococcal disease in older

adults with immunocompromising conditions in the United States

H.K. Yang, D. Zhang, P. Mavros, T. Petigara.

Merck & Co., Inc., Kenilworth,

New Jersey, USA

Background and aims:

Older adults with immunocompromising

conditions are at high risk for pneumococcal infection. Limited studies

have examined both the clinical and economic burden of pneumo-

coccal disease in this population. We assessed pneumococcal disease

rates, resource utilization and costs in US adults 65+ years with

immunocompromising conditions indicated for pneumococcal vac-

cination by ACIP.


A retrospective cohort study using medical and

pharmacy claims from Humana health plans was conducted to

compare rates and cost of all-cause pneumonia, pneumococcal

pneumonia and invasive pneumococcal disease (IPD) in older

adults 65 + y with and without immunocompromising conditions.

Conditions of interest included chronic renal disease, cancer, asplenia,

transplant and HIV.


Among 4.3 million older adults included in the analysis, 34%

had no immunocompromising condition; 16.1% had chronic renal

disease, 15.5% cancer, 0.2% asplenia, 0.1% transplant and 0.06% HIV.

Older adults with immunocompromising conditions had 3 times the

rate of all-cause and pneumococcal pneumonia, and 5 times the rate of

IPD compared to healthy older adults respectively. All-cause and

pneumococcal pneumonia rates were highest in transplant and

asplenia patients. IPD rates were highest in transplant and HIV

patients. Per IPD episode, adults with immunocompromising condi-

tions had more hospital visits and longer length of stay compared to

healthy adults

1.0 vs. 0.8 visits and 8.3 vs 6.6 days respectively, but

substantially higher costs ($13,694 vs. $10,510). IPD costs were highest

in transplant ($18,442) and HIV patients ($15,715).


Older adults with immunosuppressive conditions are at

high risk of pneumococcal disease, consume more healthcare

resources and incur greater costs.


Anti-pneumococcal vaccination in the elderly of Autonomous

Region of Madeira

C. Teixeira, D. Romeira, L. Maia.



invasive pneumococcal infections are an important

cause of morbimortality in high-risk groups, especially those over

65 years. Of the latter, the ones with comorbidities exhibit the highest

mortality rate. According to the latest American and Portuguese

standards, vaccination is recommended with Polysaccharide

Conjugate Vaccine 13-valent (PCV13) and Polysaccharide Vaccine 23-

valent (PV23) against infections by Streptococcus pneumoniae in all

immunocompetent elderly. Goal: analysis of antipneumococcal

vaccination status of the elderly population enrolled in the Health

Centres of the Autonomous Region of Madeira (ARM) and relation to

having or not a Family Doctor (FD).


Observational, transversal and analytical data collection on

vaccination with PCV13 and PV23 against Streptococcus pneumoniae

infections in the elderly enrolled in the Health Centre of ARMwith and

without FD. Data was processed with Microsoft Excel and SPSS. It was

recognized a statistical significance at p < 0.05.


Data analysis revealed a pneumococcal vaccination coverage

rate amongst the elderly of ARM of 4.6%, with a statistically significant

difference between those with and without FD. It was also observed a

difference in coverage rates among health centers, being the largest

coverage 13.7% and the lowest 1.7%.

Key conclusions:

Regarding that the pneumococcal vaccine is the

most effective way to prevent invasive pneumococcal disease and due

to low regional coverage rate, it is imperative to encourage its

implementation. Thus we intend to carry out sensitization activities to

the medical community and re-evaluate the vaccination status of this

population after 6 months.


The effect of age on seasonal influenza A prognosis

Ö. Karasahin


, P. Tosun Tasar


, O. Timur


, S. Sahin




Department of

Infectious Diseases and Clinical Microbiology, Region Training and

Research Hospital,


Department of Geriatrics, Region Training and

Research Hospital,


Department of Internal Medicine, Region Training and

Research Hospital, Erzurum,


Department of Internal Medicine, Division

of Geriatrics, Ege University Hospital, Izmir, Turkey


Seasonal flu is an acute viral infection caused by the

influenza virus. There are currently two subtypes of seasonal influenza

A circulating in humans: influenza A (H1N1) and influenza A (H3N2).

In this study we aimed to determine the mortality rate in patients

diagnosed with influenza A.

Materials and methods:

This prospective study was conducted

among patients presenting to our hospital with influenza-like illness

(ILI) between December 1 andMarch 31, 2016. According to the clinical

diagnostic criteria established by the Centers for Disease Control and

Prevention coughing, sore throat and fever were considered ILI.

Nasopharyngeal swab samples were obtained from 239 patients with

ILI symptoms.


A total of 239 patients were enrolled during the study period.

H1N1 was detected in 67 patients and H3N2 was detected in 62

patients. The age distribution of the patients was 14.0% in the 0


years group, 63.6% in the 5

64 years group and 22.5% in the

65 group.

Eleven of the patients with influenza A required treatment in the

intensive care unit. There was a significant difference between age

groups in the need for intensive care (p < 0.05), with the 5

64 age

group requiring less intensive care compared to the 0

4 and


groups. Thirteen patients died; influenza A infection was detected in 4

of the deceased patients, all of whom were in the

65 age group.


Patients over 65 years of age should be vaccinated before

contracting seasonal influenza and must be closely followed if they

become infected with influenza.


Aspiration pneumonia: a 3 year-retrospective of an inward elderly


M. Vasques


, A. Taulaigo


, M. Popovici


, J. Soares


, A. Gonçalves



E. Patarata


, T. Bernardo


, H. Gruner


, A. Panarra




Medicina 7.2

Hospital Curry Cabral -CHLC, Portugal


Aspiration pneumonia (AP) is an important cause of

mortality among the elderly. Although common, its definition is still

unclear, which has major therapeutical implications. In our hospital,

first-line therapeutic protocol consists in amoxicillin-clavulanate for

community acquired AP (CAAP) and healthcare associated AP (HAAP);

piperacillin-tazobactam for nosocomial AP (NAP), or previous recent

(<15 days) antibiotic therapy.


Clinical characterization, diagnostic and therapeutic

approach in elderly patients with AP; protocol application rate and

its impact on clinical outcome.


Retrospective study of patients with AP discharged between

2013 and 2015. Inclusion criteria: (1) age

65 years (2) clinical

evidence of pneumonia (3) risk factors for AP or presented aspiration

(4) chest x-ray.


65 patients with AP, 11 excluded[AVT1]. Mean age: 82.6 years;

98% had comorbidities. Main risk factor was previous stroke (53%).

Cultures were obtained in 44% of patients, 98% without agent isolation.

15% of patients had normal chest x-ray. Adherence to protocol was

significant (CAAP-83% HAAP-78% NAP-94%), with important clinical

improvement (CAAP-40% HAAP-44% NAP-66%). Therapeutic switch

was considerable (CA-AP 10% HA-AP 16% N-AP 8%) with favorable

Poster presentations / European Geriatric Medicine 7S1 (2016) S29