Epidemiology of Community-Acquired Pneumonia

  • IIrma Helena Koivula


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  1. Afessa, B., Greaves, W. L., & Frederick, W. R. (1995). Pneumococcal bacteremia in adults: a 14-year experience in an inner-city university hospital. Clin. Infect. Dis., 21, 345–351.PubMedGoogle Scholar
  2. Almirall, J., Morato, I., Riera, F., Verdaguer, A., Priu, R., Coll. P., Vidal, J., Murgui, L., Valls, F., Catalant, F., & Balanzo, X. (1993). Incidence of community-acquired pneumonia and Chlamydia pneumoniae infections: a prospective multi-centre study. Eur. Resp. J. 6, 14–18.Google Scholar
  3. Austrian, R. (1980). Surveillance of Pneumococcal Infection for Field Trials of Polyvalent Pneumococcal Vaccines. Publication DAB-VDP-12-84. Bethesda, Md: National Institute of Health.Google Scholar
  4. Austrian, R., & Gold, J. (1964). Pneumococcal bacteremia with especial reference to bacteremic pneumococcal pneumonia. Ann. Intern. Med., 60, 759–776.PubMedGoogle Scholar
  5. Austrian, R., Douglas, R. M., Schiffman, G., Coetzee, A. M., Koornhof, H. J., & Hayden-Smit, S. (1976). Prevention of pneumococcal infection by vaccination. Trans. Assoc. Am. Physicians, 89, 184–194.PubMedGoogle Scholar
  6. Aszkenasy, O. M., George, R. C., & Begg, N. T. (1995). Pneumococcal bacteremia and meningitis in England and Wales in 1982 to 1992. Commun. Dis. Rep. CDR Rev., 31, 45–50.Google Scholar
  7. Barker, W. H. (1986). Excess pneumonia and influenza associated hospitalization during influenza epidemics in the United States, 1970–78. Am. J. Pub. Health, 76, 761–765.PubMedGoogle Scholar
  8. Bennett, N. M., Buffington, J., & LaForce, F. M. (1992). Pneumococcal bacteremia in Monroe County, New York. Am. J. Pub. Health, 82, 1513–1516.PubMedGoogle Scholar
  9. Bentley, D. W. (1981). Pneumococcal vaccine in the institutionalized elderly: review of past and recent studies. Rev. Infect. Dis., 3(Suppl.):61–70.Google Scholar
  10. Berntsson, E., Blomberg, J., Lagergard, T., & Trollfors, B. (1985). Etiology of community-acquired pneumonia in patients requiring hospitalization. Eur. J. Clin. Microbiol. Infect. Dis., 4, 268–272.Google Scholar
  11. Bolan, G., Broome, C. V., Facklam, R. R., Plikaytis, B. D., Fraser, D. W., & Schlech, W. F. III. (1986). Pneumococcal vaccine efficacy in selected populations in United States. Ann. Intern. Med., 104, 1–6.PubMedGoogle Scholar
  12. Bouter, K. P., Diepersloot, R. J., van Romunde, L. K., Uitslager, R., Masurel, N., & Hoekstra, J. B. (1991). Effect of influenza epidemic on ketoacidosis, pneumonia and death in diabetes mellitus: a hospital register survey of 1976–1979 in The Netherlands. Diab. Res. Clin. Pract., 12, 61–68.CrossRefGoogle Scholar
  13. Brancati, F. L., Chow, J. W., Wagener, M. M., Vacarello, S. J., & Yu, V. L. (1993). Is pneumonia really the old man’s friend? Two-year prognosis after community-acquired pneumonia. Lancet, 342, 30–33.PubMedCrossRefGoogle Scholar
  14. Breiman, R. F., Spika, J. S., Navarro, V. J., Darden, P. M., & Darby, C. P. (1990). Pneumococcal bacteremia in Charleston County, South Carolina, a decade later. Arch. Intern. Med., 150, 1401–1405.PubMedCrossRefGoogle Scholar
  15. Burman, L. Å, Norrby, R., & Trollfors, B. (1985). Invasive pneumococcal infections: incidence, predisposing factors and prognosis. Rev. Infect. Dis., 7, 113–142.Google Scholar
  16. Campbell, J. F., Donohue, M. A., Mochizuki, R. B., Nevin-Woods, C. L., & Spika, J. S. (1989). Pneumococcal bacteremia in Hawaii: initial findings of a pneumococcal disease prevention project. Hawaii Med. J., 48, 513–518.PubMedGoogle Scholar
  17. Centers for Disease Control and Prevention (1995). Pneumonia and influenza death rates—United States, 1979–1994. MMWR, 44, 535–537.Google Scholar
  18. Central Statistical Office of Finland (1985–1988, 1989). Statistical Year Book of Finland. Helsinki, Finland: State Printing Office.Google Scholar
  19. Chakraverty, P., Cunningham, P., Shen, G. Z., & Pereira, M. S. (1986). Influenza in the United Kingdom 1982—1985. J. Hyg., 97, 347–358.CrossRefGoogle Scholar
  20. Cullinan, P. (1988). Respiratory disease in England and Wales. Thorax, 43, 949–954.PubMedGoogle Scholar
  21. Davidson, M., Parkinson, A. J., Bulkow, L. R., Fitzgerald, M. A., Peters, H. V, & Parks, D. J. (1994). The epidemiology of invasive pneumococcal disease in Alaska, 1986–1990-ethnic differences and opportunities for prevention. J. Infect. Dis., 170, 368–376.PubMedGoogle Scholar
  22. Diepersloot, R. J., Bouter, K. P., Hoekstra, J. B. (1990). Influenza infection and diabetes mellitus. Case for annual vaccination. Diab. Care, 13, 876–882.Google Scholar
  23. Donowitz, G. R., & Mandell, G. L. (1995). Acute pneumonia, in: Principles and Practice of Infectious Disease, 4th ed. (G.L. Mandell, J.E. Bennett, & R. Dolin, eds.) New York: Churchill Livingstone, pp. 619–637.Google Scholar
  24. Dorff, G. J., Rytel, M. W., Farmer, S. G., & Scanlon, G. (1973). Etiologies and characteristic features of pneumonias in a municipal hospital. Am. J. Med. Sci., 66, 349–358.Google Scholar
  25. Dulake, C., & Selkon, J. (1982). The incidence of pneumonia in the UK—preliminary findings from Newcastle and London. Roy. Soc. Med. Symp. Series, 27, 87–94.Google Scholar
  26. Farr, B. M., Bartlett, C. L. R., Wadsworth, J., & Miller, D. L. (1988). A case-control study of risk factors for community acquired pneumonia. 28th Interscience Conference on Antimicrobial Agents and Chemotherapy, October, 23–26, Los Angeles. Abstract 1294.Google Scholar
  27. Farr, B. M., Sloman, A. J., & Fisch, M. J. (1991). Predicting death in patients hospitalized for community-acquired pneumonia. Ann. Intern. Med., 115, 428–436.PubMedGoogle Scholar
  28. Farr, B. M., Johnston, B. L., Cobb, D. K., Fisch, M. J., Germanson, T. P., Adal, K. A., Anglim, A. M. (1995). Preventing pneumococcal bacteremia in patients at risk. Results of a matched case-control study. Arch. Intern. Med., 155, 2336–2440.PubMedCrossRefGoogle Scholar
  29. Fedson, D. S., & Baldwin, J. A. (1982). Previous hospital care as a risk factor for pneumonia. Implications for immunization with pneumococcal vaccine. JAMA, 246, 1989–1995.Google Scholar
  30. Fedson, D. S., & Musher, D. M. (1994). Pneumococcal vaccine. In: Vaccines, 2d ed. (S. A. Plotkin & E. A. Mortimer, eds.). Philadelphia: W. B. Saunders Company, pp. 517–564.Google Scholar
  31. Fedson, D., Henrichsen, J., & Mäkelä, P. H. (1989). Immunization of elderly people with polyvalent pneumococcal vaccine. Infection, 17, 437–441.PubMedCrossRefGoogle Scholar
  32. Fedson, D. S., Harward, M. P., Reid, R. A., & Kaiser, D. L. (1990). Hospital-based pneumococcal immunization. Epidemiologic rationale from the Shenandoah study. JAMA, 264, 1117–1122.PubMedCrossRefGoogle Scholar
  33. Fekety, F. R., Caldwell, J., Gump, D., Johnson, J. E., Maxson, W., Mulholland, J., & Thoburn, R. (1971). Bacteria, viruses and mycoplasmas in acute pneumonia in adults. Am. Rev. Respir. Dis., 104, 499–507.PubMedGoogle Scholar
  34. Filice, G. A., Darby, C. P., & Fraser, D. W. (1980). Pneumococcal bacteremia in Charleston County, South Carolina. Am. J. Epidemiol., 112, 828–835.Google Scholar
  35. Fine, M. J., Smith, D. N., & Singer, D. E. (1990). Hospitalization decision in patients with community-acquired pneumonia: a prospective cohort study. Am. J. Med., 89, 713–721.PubMedGoogle Scholar
  36. Fine, M. J., Singer, D. E., Hanusa, B. H., Lave, J. R., & Kapoor, W. N. (1993). Validation of a pneumonia prognostic index using the MedisGroups comparative hospital database. Am. J. Med., 94, 153–159.PubMedCrossRefGoogle Scholar
  37. Fine, M. J., Smith, M. A., Carson, C. A., Mutha, S., Sankey, S. S., Weissfeld, L. A., Kapoor, W. N. (1996). Prognosis and outcomes of patients with community-acquired pneumonia. A meta-analysis. JAMA, 275, 134–141.PubMedCrossRefGoogle Scholar
  38. Fine, M. L., Auble, T. E., Yealy, D. M., Hanusa, B. H, Weissfeld, L. A., Singer, D. E, Coley, C. M, Marrie, T. J., & Kapoor, W. N. (1997). A prediction rule to identify low-risk patients with community-acquired pneumonia. N. Engl. J. Med., 336, 243–250.PubMedCrossRefGoogle Scholar
  39. Finkelstein, M. S., Petkun, W. M, Freedman, M. L., & Antopol, S. C. (1983). Pneumococcal bacteremia in adults. J. Am. Geriatr. Soc., 31, 19–27.PubMedGoogle Scholar
  40. Foy, H. M., Cooney, M. K., Allan, L., & Kenny, G. E. (1979). Rates of pneumonia during influenza epidemics in Seattle 1964 to 1975. JAMA, 241, 253–258.PubMedCrossRefGoogle Scholar
  41. Gable, C. B, Holzer, S. S, Engelhart, L., Friedman, R. B, Smeltz, F, Schroeder, D., & Baum, K. (1990). Pneumococcal vaccine. Efficacy and associated cost savings. JAMA, 264, 2910–2915.PubMedCrossRefGoogle Scholar
  42. Gaillat, J., Zmirou, D., Mallaret, M. R., Rouhan, D., Bru, J. P., Stahl, J. P, Delormas, P., & Micoud, D. (1985). Essai clinique du vaccin antipneumococcique chez des personnes âgées vivant en institution. Revue d’Epidemiologie et de Sante Publique, 33, 437–444.PubMedGoogle Scholar
  43. Gilbert, K., & Fine, M. J. (1994). Assessing prognosis and predicting outcomes in community-acquired pneumonia. Semin. Respir. Inf., 9, 140–152.Google Scholar
  44. Glezen, W. P, Decker, M., & Perotta, D. (1987). Survey of underlying conditions of persons hospitalized with acute respiratory disease during influenza epidemics in Houston, 1978–1981. Am. Rev. Respir. Dis., 136, 550–555.PubMedGoogle Scholar
  45. Gransden, W. R, Eykyn, S. J., & Phillips, I. (1985). Pneumococcal bacteremia: 325 episodes diagnosed at St. Thomas’s Hospital. Br. Med. J., 290, 505–508.CrossRefGoogle Scholar
  46. Granton, J. T, & Grossman, R. F. (1993). Community-acquired pneumonia in the elderly patient. Clinical features, epidemiology, and treatment. Clin. Chest. Med., 14, 537–553.PubMedGoogle Scholar
  47. Groop, L., Forsén, B., Niemelä, R., Pitkänen, M.-R., & Nordmyr, M. (1979). Tartuntatutien hoito terveyskeskuksessa (Management of infectious diseases in a municipal health center), (In Finnish). Suom Lääkäril, 34. 2772–2776.Google Scholar
  48. Haglund, L. A, Istre, G. R, Pickett, D. A, Welch, D. F, Fine, D. P., and the Pneumococcus Study Group. (1993). Invasive pneumococcal disease in Central Oklahoma: emergence of high-level penicillin resistance and multiple antibiotic resistance. J. Infect. Dis., 168, 1532–1536.PubMedGoogle Scholar
  49. Hasley, P. B, Albaum, M. N, Li, Y. H, Fuhrman, C. R, Britton, C. A., Marrie, T. J, Singer, D. E, Coley, C. M, Kapoor, W. N., & Fine, M. J. (1996). Do pulmonary radiographic findings at presentation predict mortality in patients with community-acquired pneumonia? Arch. Intern. Med., 156, 2206–2212.PubMedCrossRefGoogle Scholar
  50. Hedlund, J. U, Örtqvist, Å. B., Kalin, M, Scalia-Tomba, G., & Giesecke, J. (1992). Risk of pneumonia in patients previously treated in hospital for pneumonia. Lancet, 340, 396–397.PubMedCrossRefGoogle Scholar
  51. Hedlund, J. U, Örtqvist, A. B., Kalin, M. E., & Granath, F. (1993). Factors of importance for the long-term prognosis after hospital treated pneumonia. Thorax, 48, 785–789.PubMedGoogle Scholar
  52. Hedlund, J., Svenson, S. B., Kalin, M., Henrichsen, J., Olsson-Liljequist, B., Möllerberg, G., & Källenius, G. (1995). Incidence, capsular types, and antibiotic susceptibility of invasive Streptococcus pneumoniae in Sweden. Clin. Infect. Dis., 21, 948–953.PubMedGoogle Scholar
  53. Hedlund, J, Kalin, M., & Örtqvist, A (1997). Recurrence of pneumonia in middle-aged and elderly adults after hospital-treated pneumonia: aetiology and predisposing conditions. Scand. J. Infect. Dis., 29, 387–392.PubMedCrossRefGoogle Scholar
  54. Holmberg, H. (1987). Aetiology of community-acquired pneumonia in hospital treated patients. Scand. J. Infect. Dis., 19, 491–501.PubMedGoogle Scholar
  55. Honkanen, P. O, Keistinen, T., Miettinen, L., Herva, E., Sankilampi, U., Läärä, E., Leinonen, M., Kivelä, S.-L., Mäkelä, P. H. The incremental effectiveness of pneumococcal vaccine on simultaneously administered influenza vaccine in preventing pneumonia and pneumococcal pneumonia among persons aged 65 years or older. Vaccine, 17, 2493–2500.Google Scholar
  56. Istre, G. R., Tarpay, M., Anderson, M., Pryor, A., Welch, D., & the Pneumococcus Study Group. (1987). Invasive disease due to Streptococcus pneumoniae in an area with high rate of relative penicillin resistance. J. Infect. Dis., 156, 732–735.PubMedGoogle Scholar
  57. Jokinen, C., Heiskanen, L., Juvonen, H., Kallinen, S., Karkola, K., Korppi, M., Kurki, S., Rönnberg, P.-R., Seppä, A., Soimakallio, L., Stén, M., Tanska, S., Tarkiainen, A., Tukiainen, H., Pyörälä, K., & Mäkelä, P. H. (1993). Incidence of community-acquired pneumonia in the population of four municipalities in Eastern Finland. Am. J. Epidemiol., 137, 977–988.PubMedGoogle Scholar
  58. Jokinen, C., Heiskanen, L., Juvonen, H., Kallinen, S., Kleemola, M., Koskela, M., Leinonen, M., Rönnberg, P.-R., Saikku, P., Stén, M., Tarkiainen, A., Tukiainen, H., Pyörälä, K., & Mäkelä, P. H. (in press). Microbial etiology of community-acquired pneumonia in the adult population of four municipalities in Eastern Finland. Clin. Infect. Dis..Google Scholar
  59. Kauppinen, M. T., Herva, E., Kujala, P., Leinonen, M., Saikku, P., Syrjälä, H. (1995). The etiology of community-acquired pneumonia among hospitalized patients during a Chlamydia pneumoniae epidemic in Finland. J. Infect. Dis., 172, 1330–1335.PubMedGoogle Scholar
  60. Kerttula, Y, Leinonen, M., Koskela, M., & Mäkelä, P. H. (1987). The aetiology of pneumonia. Application of bacterial serology and basic laboratory methods. J. Infect., 14, 21–30.PubMedCrossRefGoogle Scholar
  61. Koivula, I., Stén, M., & Mäkelä, P. H. (1994). Risk factors for pneumonia in the elderly. Am. J. Med., 96, 313–320.PubMedCrossRefGoogle Scholar
  62. Koivula, I., Stén, M., & Mäkelä, P. H. (1997). Clinical efficacy of the pneumococcal vaccine in the elderly: a randomized, single-blind population-based trial. Am. J. Med., 103, 282–290.CrossRefGoogle Scholar
  63. Koivula, L, Stén, M., & Mäkelä, P. H. (1999). Prognosis after community-acquired pneumonia in the elderly—a population-based 12-year follow-up study. Arch. Intern. Med., 159, 1550–1555.PubMedCrossRefGoogle Scholar
  64. Kramer, M. R., Rudensky, B., Hadas-Halperin, I., Isachson, M., & Melzer, E. (1987). Pneumococcal bacteremia—no change in mortality in 30 years: Analysis of 104 cases and review of the literature. Isr. J. Med. Sci., 23, 174–180.PubMedGoogle Scholar
  65. Kuikka, A., Syrjänen, J., Renkonen, O-V., & Valtonen, V. (1992). Pneumococcal bacteremia during a recent decade. J. Infect., 24, 157–168.PubMedCrossRefGoogle Scholar
  66. Lääveri, T., Nikoskelainen, J., Meurman, O., Eerola, E., & Kotilainen, P. (1996). Bacteraemic pneumococcal disease in a teaching hospital in Finland. Scand, J. Infect. Dis., 28, 41–46.CrossRefGoogle Scholar
  67. LaCroix, A. Z., Lipson, S., Miles, T., & White, L. (1989). Prospective study of pneumonia hospitalizations and mortality of U.S. older people: the role of chronic conditions, health behaviors and nutritional status. Pub. Health Rep., 104, 350–369.Google Scholar
  68. Lange, P., Vestbo, J., Nyboe, J. (1995). Risk factors for death and hospitalization from pneumonia. A prospective study of a general population. Eur. Respir. J., 8, 1694–1698.PubMedCrossRefGoogle Scholar
  69. Leech, J. A., Gervais, A., & Ruben, F. L. (1987). Efficacy of pneumococcal vaccine in severe chronic obstructive pulmonary disease. Can. Med. Assoc. J., 136, 361–365.Google Scholar
  70. Levy, M., Dromer, F., Brion, N., Leturdu, F., & Carbon, C. (1988). Community-acquired pneumonia. Importance of initial noninvasive bacteriologic and radiographic investigations. Chest., 92, 43–48.Google Scholar
  71. Lieberman, D., Schlaeffer, F., Boldur, I., Lieberman, D., Horowitz, M. G., Leinonen, M., Horowitz, O., Manor, E., & Porath, A. (1996). Multiple pathogens in adult patients admitted with community-acquired pneumonia: a one year prospective study of 346 consecutive patients. Thorax, 51, 179–184.PubMedGoogle Scholar
  72. Lieberman, D., Lieberman, D., Schlaeffer, F., & Porath, A. (1997). Community-acquired pneumonia in old age: a prospective study of 91 patients admitted from home. Age Ageing, 26, 69–75.PubMedGoogle Scholar
  73. Lipsky, B. A., Boyko, E. J., Inui, T. S., Koepsell, T. D. (1986). Risk factors for acquiring pneumococcal infections. Arch. Intern. Med., 146, 2179–2185.PubMedCrossRefGoogle Scholar
  74. Macfarlane, J. (1987). Community-acquired pneumonia. Br. J. Dis. Chest, 81, 116–127.PubMedGoogle Scholar
  75. Macfarlane, J. (1994). An overview of community-acquired pneumonia with lessons learned from the British Thoracic Society Study. Semin. Respir. Infect., 9, 153–165.PubMedGoogle Scholar
  76. Macfarlane, J. T., Finch, R. G., Ward, M. J., & Macrae, A. D. (1982). Hospital study of adult community-acquired pneumonia. Lancet, 2, 255–258.PubMedGoogle Scholar
  77. Macfarlane, J. T., Colville, A., Guion, A., Macfarlane, R. M., & Rose, D. H. (1993). Prospective study of aetiology and outcome of adult lower-respiratory-tract infections in the community. Lancet, 34, 511–514.Google Scholar
  78. Mäkelä, P. H., Jokinen, C., Koivula, I., Mäkelä, M., & Pyhälä, R. (1993). Pneumonia in the elderly and cost-effectiveness of influenza vaccination, in: Options for the Control of Influenza II (A. P. Hannoun, H. D. Klenk, & F. L. Ruben, eds.). New York: Elsevier Science Publishers, pp. 63–68.Google Scholar
  79. Marrie, T. J. (1990). Epidemiology of community-acquired pneumonia in the elderly. Semin. Respir. Infect., 5, 260–268.PubMedGoogle Scholar
  80. Marrie, T. J., Durant, H., & Kwan, C. (1989). Community-acquired pneumonia requiring hospitalization: 5-year prospective study. Rev. Infect. Dis., 11, 586–599.PubMedGoogle Scholar
  81. Marston, B. J., Plouffe, J. F, File, T. M., Hackman, B. A., Salström, S., Lipman, H. B., Kolczak, M. S., & Breiman, R. F. (1997). Incidence of community-acquired pneumonia requiring hospitalization. Arch. Intern. Med., 157, 1709–1718.PubMedCrossRefGoogle Scholar
  82. McConnochie, K. M., Hall, C. B., & Barker, W. H. (1988). Lower respiratory tract illness in the first two years of life: epidemiologic patterns and costs in a suburban pediatric practice. Am. J. Pub. Health, 78, 34–39.PubMedGoogle Scholar
  83. Metlay, J. P., Schulz, R., Li, Y. H., Singer, D. E., Marrie, T. J., Coley, C. M., Hough, L. J., Obrosky, D. S., Kapoor, W. N., & Fine, M. J. (1997). Influence of age on symptoms at presentation in patients with community-acquired pneumonia. Arch. Intern. Med., 157, 1453–1459.PubMedCrossRefGoogle Scholar
  84. Moss, J. M. (1980). Pneumococcal infection in diabetes mellitus. Is this a justification for immunization? JAMA, 22, 2301–2303.Google Scholar
  85. Mufson, M. A., Oley, G., & Hughey, D. (1982). Pneumococcal disease in a medium-sized community in the United States. JAMA, 248, 1486–1489.PubMedCrossRefGoogle Scholar
  86. Murphy, T. F, & Fine, B. C. (1984). Bacteremie pneumococcal pneumonia in the elderly. Am. J. Med. Sci., 288, 114–118.PubMedGoogle Scholar
  87. Murphy, T. F, Henderson, F. W., Clyde, W. A. Jr., Collier, A. M., & Denny, F. W. (1981). Pneumonia: an eleven-year study in a pediatric practice. Am. J. Epidemiol., 113, 12–21.PubMedGoogle Scholar
  88. Nichol, K. L., Margolis, K. L., Wuorenma, J., Von Sternberg, T. (1994). The efficacy and cost effectiveness of vaccination against influenza among elderly persons living in the community. N. Engl. J. Med., 331, 778–784.PubMedCrossRefGoogle Scholar
  89. Nielsen, S. V, & Henrichsen, J. (1992). Capsular types of Streptococcus pneumoniae isolated from blood and CSF during 1982–1987. Clin. Infect. Dis., 15, 794–798.PubMedGoogle Scholar
  90. Örtqvist, Å., Grepe, A., Julander, I., & Kalin, M. (1988). Bacteremic pneumococcal pneumonia in Sweden: clinical course and outcome and comparison with non-bacteremic pneumococcal and mycoplasmal pneumonias. Scand. J. Infect. Dis., 20, 163–171.PubMedGoogle Scholar
  91. Örtqvist, Å., Hedlund, J., Grillner, L., Jalonen, E., Kallings, I., Leinonen, M., & Kalin, M. (1990). Aetiology, outcome and prognostic factors in community-acquired pneumonia requiring hospitalization. Eur. Respir. J., 3, 1105–1113.PubMedGoogle Scholar
  92. Örtqvist, Å., Hedlund, J., Burman, L.-Å., Höfer, M., Leinonen, M., Lindblad, L, Sundelöf, B., Kalin, M., & Swedish Pneumococcal Vaccination Study Group. (1998). Randomized trial of 23-valent pneumococcal capsular polysaccharide vaccine in prevention of pneumonia in middle-aged and elderly people. Lancet, 351, 399–403.PubMedGoogle Scholar
  93. Oseasohn, R., Skipper, B. E., & Tempest, B. (1978). Pneumonia in a Navajo Community. Am. Rev. Respir. Dis., 117, 1003–1009.PubMedGoogle Scholar
  94. Pastor, P., Medley, F., & Murphy, T. V. (1998). Invasive pneumococcal disease in Dallas County, Texas: results from population-based surveillance in 1995. Clin. Infect. Dis., 26, 5.Google Scholar
  95. Patrick, K. M., & Woolley, F. R. (1981). A cost-benefit analysis of immunization for pneumococcal pneumonia. JAMA, 245, 473–477.PubMedCrossRefGoogle Scholar
  96. Plouffe, J. F., Breiman, R. F., Facklam, R. R., & the Franklin County Pneumonia Study Group. (1996). Bacteremia with Streptococcus pneumoniae in adults. Implications for therapy and prevention. JAMA, 275, 194–198.PubMedCrossRefGoogle Scholar
  97. Rello, J., Rodriguez, R., Jubert, P., Alvarez, B., & the Study Group for Severe Community-Acquired Pneumonia. (1996). Severe community-acquired pneumonia in the elderly: epidemiology and prognosis. Clin. Infect. Dis., 23, 723–728.PubMedGoogle Scholar
  98. Research Committee of the British Thoracic Society and the Public Health Laboratory Service (1987). Community-acquired pneumonia in adults in British hospitals in 1982–1983: A survey of aetiologic, mortality, prognostic factors and outcome. Q. J. Med., 62, 195–220.Google Scholar
  99. Riley, I. D., Tarr, P. I., & Andrews, M. (1977). Immunization with a polyvalent pneumococcal vaccine. Reduction of adult respiratory mortality in a New Guinea Highlands community. Lancet, 1, 1338–1341.PubMedGoogle Scholar
  100. Ruben, F. L., Norden, C. W., & Korica, Y. (1984). Pneumococcal bacteremia at a medical/surgical hospital for adults between 1975 and 1980. Am. J. Med., 77, 1091–1094.PubMedCrossRefGoogle Scholar
  101. Salive, M. E., Satterfield, S., Ostfeld, A. M., Wallace, R. B., & Havlik, R. J. (1993). Disability and cognitive impairment are risk factors for pneumonia-related mortality in older adults. Pub. Health Rep., 108, 314–322.Google Scholar
  102. Sankilampi, U. (1997). Streptococcus pneumoniae and the elderly: an epidemiological and serological study focusing on the potential of the polysaccharide vaccine. Doctoral dissertation, Universitatis Ouluensis.Google Scholar
  103. Sankilampi, U., Herva, E., Haikala, R., Liimatainen, O., Renkoncn, O.-V., & Leinonen, M. (1997). Epidemiology of invasive infections in adults in Finland. Epidemiol. Infect., 118, 7–15.PubMedCrossRefGoogle Scholar
  104. Säynäjäkangas, P., Keistinen, T., Honkanen, P. O., & Kivelä, S.-L. (1997). Hospital discharges for pneumonia in Finland between 1972–1993 in the population aged 65 years or over. Age Ageing, 26, 269–273.PubMedGoogle Scholar
  105. Shapiro, E. D., & Clemens, J. D. (1984). A controlled evaluation of the protective efficacy of pneumococcal vaccine for patients at high risk of serious pneumococcal infections. Ann. Intern. Med., 101, 325–330.PubMedGoogle Scholar
  106. Shapiro, E. D., Berg, A. T, Austrian, R., Schroeder, D., Parcells, V., Margolis, A., Adair, R. K., & Clemens, J. D. (1991). The protective efficacy of polyvalent pneumococcal polysaccharide vaccine. N. Engl. J. Med., 325, 1453–1460.PubMedGoogle Scholar
  107. Simberkoff, M. S., Cross, A. P., Al-Ibrahim, M., Baltch, A. L., Geisler, P. J., Nadler, J., Richmond, A. S., Smith, R. P., Schiffman, G., & Shephard, D. S. (1986). Efficacy of pneumococcal vaccine in high-risk patients. N. Engl. J. Med., 315, 1318–1327.PubMedCrossRefGoogle Scholar
  108. Sims, R. V., Steinmann, W. C., McConville, J. H., King, L., Zwick, W. C., & Schwart, J. S. (1988). The clinical effectiveness of pneumococcal vaccine in the elderly. Ann. Intern. Med., 108, 653–657.PubMedGoogle Scholar
  109. Smit, P., Oberholzer, D., Hayden-Smith, S., Koornhof, H. J., & Hilleman, M. R. (1977). Protective efficacy of pneumococcal polysaccharide vaccines. JAMA, 238, 2613–2616.PubMedCrossRefGoogle Scholar
  110. Smith, M. D., Stuart, J., Andrews, N. J., Telfer Brunton, W. A., & Cartwright, K. A. V. (1998). Invasive pneumococcal infection in south and west England. Epidemiol. Infect., 120, 117–123.PubMedCrossRefGoogle Scholar
  111. Trotman, J., Hughes, B., & Mollison. L. (1995). Invasive pneumococcal disease in central Australia. Clin. Infect. Dis., 20, 1553–1556.PubMedGoogle Scholar
  112. Venkatesan, P., Gladman, J., Macfarlane, J. T., Barer, D., Berman, P., Kinnear, W., & Finch, R. G. (1990). A hospital study of community-acquired pneumonia in the elderly. Thorax, 45, 254–258.PubMedCrossRefGoogle Scholar
  113. Virtanen, M., & Peltola, H. Bacteremia and purulent meningitis in Finland, 1982. An analysis of positive blood cultures and cerebrospinal fluid cultures in 1976–1980 (in Finnish). Duodecim., 98, 1315–1325.Google Scholar
  114. Woodhead, M. A., Macfarlane, J. T., Rodgers, F. G., Laverick, A., Pilkington, R., & Macrae, A. D. (1987). Prospective study of aetiology and outcome of pneumonia in the community. Lancet, 1, 671–674.PubMedGoogle Scholar
  115. Zangwill, K. M., Vadheim, C. M., Vannier, A. M., Hemenway, L. S., Greenberg, D. P., & Ward, J. I. (1996). Epidemiology of invasive pneumococcal disease in Southern California: implications for design and conduct of a pneumococcal conjugate vaccine trial. J. Infect. Dis., 174, 752–759.PubMedGoogle Scholar
  116. Zweig, S., Lawhorne, L., & Post, R. (1990). Factors predicting mortality in rural elderly hospitalized for pneumonia. J. Fam. Pract., 30, 153–159.PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  • IIrma Helena Koivula
    • 1
  1. 1.Department of Medicine, Division of Infectious Diseases (4620)Kuopio University HospitalKuopioFinland

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