Pneumococcal disease burden in high-risk older adults: Exploring impact of comorbidities, long-term care facilities, antibiotic resistance, and immunization policies through a narrative literature review

Abstract

This study aims to provide a comprehensive review of literature on pneumococcal disease burden in high-risk older adults aged ≥65 with focus on impact of comorbidities, long-term care facilities (LTCFs), antibiotic resistance, and vaccination policies across various countries. Research showed that the disease burden and the prevalence of antibiotic-resistant pneumococci was higher in the elderly, particularly those residing in LTCFs, and with comorbidities. These individuals are at high risk of infection with antibiotic-resistant serotypes 10A, 11A, and 15B. The vaccination strategies and national guidelines for pneumococcal vaccines in the elderly vary across countries. Some countries focus on single-dose strategies, while others recommend sequential vaccinations with varying intervals. Although vaccination policies are well-established for the elderly, they are not as well-established for high-risk elderly groups, and this review underscores the need for more tailored vaccination strategies for these groups.

Keywords: Pneumococcal disease; antibiotic resistance; high-risk elderly population; long-term care facility; serotype distribution; vaccination strategies.

Figure 1A.

The incidence rates (cases per 100,000 person-years) of pneumococcal pneumonia among adults, stratified by chronic medical conditions and age groups. The data were adapted from reference 19.

Figure 1B.

The incidence rate of invasive pneumococcal diseases (IPDs, cases per 100,000 person-years), stratified by chronic medical conditions and age groups. The data were adapted from reference 19.

Figure 2.

Annual cost for invasive pneumococcal diseases (per 100,000 person-years), stratified by the numbers of chronic medical conditions. The data was adapted from reference 39.