{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T17:26:55Z","timestamp":1784222815580,"version":"3.55.0"},"reference-count":28,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Streptococcus pneumoniae (SP) has high worldwide incidence and related morbidity and mortality, particularly among children and geriatric patients. SP infection could manifest with pneumonia, bacteremia, sepsis, meningitis, and osteomyelitis. This was a retrospective study aimed at evaluating the incidence, comorbidities, and factors associated with in-hospital mortality of pneumococcal disease-related hospitalization in a province in southern Italy from the years 2015 to 2022. This study was performed in the Local Health Authority (LHA) of Pescara. Data were collected from hospital discharge records (HDRs): this database is composed of 288,110 discharge records from LHA Pescara\u2019s hospitals from 2015 to 2022. Streptococcus Pneumoniae-related hospitalizations were about 5% of the hospitalizations; 67% of these were without comorbidities; 21% were with one comorbidity; and 13% were with two or more comorbidities. Regarding mortality of SP infection, the most affected age group was older people, with the percentage of cases among the over-65s being more than 50% compared to the other age groups. HDRs represent a valid and useful epidemiological tool for evaluating the direct impact of pneumococcal disease on the population and also indirectly for evaluating the effectiveness of vaccination strategies and directing them.<\/jats:p>","DOI":"10.3390\/vaccines11081324","type":"journal-article","created":{"date-parts":[[2023,8,5]],"date-time":"2023-08-05T10:21:39Z","timestamp":1691230899000},"page":"1324","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["The Burden of Streptococcus pneumoniae-Related Admissions and In-Hospital Mortality: A Retrospective Observational Study between the Years 2015 and 2022 from a Southern Italian Province"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7310-2460","authenticated-orcid":false,"given":"Fabrizio","family":"Cedrone","sequence":"first","affiliation":[{"name":"Hospital Healthcare Management, Local Health Autority of Pescara, Via Renato Paolini, 65124 Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Montagna","sequence":"additional","affiliation":[{"name":"Postgraduate School of Hygiene and Preventive Medicine, Universit\u00e0 Politecnica delle Marche, 60100 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livio","family":"Del Duca","sequence":"additional","affiliation":[{"name":"Hospital Healthcare Management, Local Health Autority of Pescara, Via Renato Paolini, 65124 Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Camplone","sequence":"additional","affiliation":[{"name":"Postgraduate School of Hygiene and Preventive Medicine, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Mazzocca","sequence":"additional","affiliation":[{"name":"Postgraduate School of Hygiene and Preventive Medicine, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Carfagnini","sequence":"additional","affiliation":[{"name":"Hospital Healthcare Management, Local Health Autority of Pescara, Via Renato Paolini, 65124 Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valterio","family":"Fortunato","sequence":"additional","affiliation":[{"name":"Hospital Healthcare Management, Local Health Autority of Pescara, Via Renato Paolini, 65124 Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7047-7611","authenticated-orcid":false,"given":"Giuseppe","family":"Di Martino","sequence":"additional","affiliation":[{"name":"Department of Medicine and Ageing Sciences, \u201cG. d\u2019Annunzio\u201d University of Chieti-Pescara, 66100 Chieti, Italy"},{"name":"Unit of Hygiene, Epidemiology and Public Health, Local Health Authority of Pescara, 65100 Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"130","DOI":"10.3810\/pgm.2010.03.2130","article-title":"Burden of community-acquired pneumonia in North American adults","volume":"122","author":"File","year":"2010","journal-title":"Postgrad. Med."},{"key":"ref_2","unstructured":"WHO (2023, May 31). Pneumococcal Disease, Available online: https:\/\/www.who.int\/teams\/health-product-policy-and-standards\/standards-and-specifications\/vaccine-standardization\/pneumococcal-disease."},{"key":"ref_3","unstructured":"EpiCentro (2023, May 31). Epidemiological Data in Italy. Available online: https:\/\/www.epicentro.iss.it\/en\/invasive-bacterial-diseases\/epidemiology-italy."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1093\/cid\/ciy1139","article-title":"Burden of Streptococcus Pneumoniae Sepsis in Children After Introduction of Pneumococcal Conjugate Vaccines: A Prospective Population-Based Cohort Study","volume":"69","author":"Asner","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1111\/j.1368-5031.2006.00858.x","article-title":"Controlling Invasive Pneumococcal Disease: Is Vaccination of at-Risk Groups Sufficient?","volume":"60","author":"Fletcher","year":"2006","journal-title":"Int. J. Clin. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1017\/S0950268806007199","article-title":"Burden of Paediatric Invasive Pneumococcal Disease in Europe, 2005","volume":"135","author":"McIntosh","year":"2007","journal-title":"Epidemiol. Infect."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1086\/313608","article-title":"Which Pneumococcal Serogroups Cause the Most Invasive Disease: Implications for Conjugate Vaccine Formulation and Use, Part I","volume":"30","author":"Hausdorff","year":"2000","journal-title":"Clin. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e197","DOI":"10.1016\/j.ijid.2009.05.010","article-title":"Burden of Invasive Pneumococcal Disease and Serotype Distribution among Streptococcus Pneumoniae Isolates in Young Children in Europe: Impact of the 7-Valent Pneumococcal Conjugate Vaccine and Considerations for Future Conjugate Vaccines","volume":"14","author":"Isaacman","year":"2010","journal-title":"Int. J. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.4161\/hv.27947","article-title":"Estimating the Burden of Hospitalization for Pneumococcal Pneumonia in a General Population Aged 50 Years or Older and Implications for Vaccination Strategies","volume":"10","author":"Amodio","year":"2014","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/thx.2009.129502","article-title":"Clinical and Economic Burden of Community-Acquired Pneumonia among Adults in Europe","volume":"67","author":"Welte","year":"2012","journal-title":"Thorax"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"4955","DOI":"10.1016\/j.vaccine.2010.05.030","article-title":"Clinical and Economic Burden of Pneumococcal Disease in Older US Adults","volume":"28","author":"Weycker","year":"2010","journal-title":"Vaccine"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Di Martino, G., Di Giovanni, P., Cedrone, F., D\u2019Addezio, M., Meo, F., Scampoli, P., Romano, F., and Staniscia, T. (2021). The Burden of Diabetes-Related Preventable Hospitalization: 11-Year Trend and Associated Factors in a Region of Southern Italy. 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Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/j.vaccine.2022.12.004","article-title":"Cost-Effectiveness of Pneumococcal Vaccines among Adults Aged 65 Years and Older in China: A Comparative Study","volume":"41","author":"Guo","year":"2023","journal-title":"Vaccine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.jval.2022.10.006","article-title":"Pneumococcal Vaccination in Children: A Systematic Review and Meta-Analysis of Cost-Effectiveness Studies","volume":"26","author":"Syeed","year":"2023","journal-title":"Value Health"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Cedrone, F., Di Martino, G., Di Giovanni, P., Greco, E., Trebbi, E., Romano, F., and Staniscia, T. (2022). Reduction in Hospital Admissions for Cardiovascular Diseases (CVDs) during the Coronavirus Disease 2019 (COVID-19) Pandemic: A Retrospective Study from a Southern Italian Region in the Year 2020. Healthcare, 10.","DOI":"10.3390\/healthcare10050871"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Di Martino, G., Cedrone, F., Di Giovanni, P., Romano, F., and Staniscia, T. (2022). Impact of COVID-19 Pandemic on Oncological Surgery Activities: A Retrospective Study from a Southern Italian Region. Healthcare, 10.","DOI":"10.3390\/healthcare10112329"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1007\/s12325-020-01248-7","article-title":"Burden of Community-Acquired Pneumonia and Unmet Clinical Needs","volume":"37","author":"Sarda","year":"2020","journal-title":"Adv. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.pulmoe.2019.10.003","article-title":"Pneumonia Mortality, Comorbidities Matter?","volume":"26","author":"Hespanhol","year":"2020","journal-title":"Pulmonology"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Barmanray, R.D., Cheuk, N., Fourlanos, S., Greenberg, P.B., Colman, P.G., and Worth, L.J. (2022). In-Hospital Hyperglycemia but Not Diabetes Mellitus Alone Is Associated with Increased in-Hospital Mortality in Community-Acquired Pneumonia (CAP): A Systematic Review and Meta-Analysis of Observational Studies Prior to COVID-19. BMJ Open Diabetes Res. Care, 10.","DOI":"10.1136\/bmjdrc-2022-002880"},{"key":"ref_22","first-page":"115","article-title":"Total Parenteral Nutrition Is Associated with Worse Hospital Outcomes among Elderly Diabetic Patients: A Propensity Score Matched Analysis on Discharge Records","volume":"173","author":"Cedrone","year":"2022","journal-title":"Clin. Ther."},{"key":"ref_23","first-page":"467","article-title":"Predictors of Prolonged Hospitalization and In-Hospital Mortality After Hip Fracture: A Retrospective Study on Discharge Registry","volume":"34","author":"Zecca","year":"2022","journal-title":"Ann. Ig."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.clinthera.2019.01.014","article-title":"Preoperative Frailty Evaluation: A Promising Risk-stratification Tool in Older Adults Undergoing General Surgery","volume":"41","author":"Ko","year":"2019","journal-title":"Clin Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1080\/02699052.2019.1683897","article-title":"Predictors of in-hospital mortality following hypoxic-ischemic brain injury: A population-based study","volume":"34","author":"Jacob","year":"2020","journal-title":"Brain Inj."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Amodio, E., Vitale, F., d\u2019Angela, D., Carrieri, C., Polistena, B., Spandonaro, F., Pagliaro, A., and Montuori, E.A. (2023). Increased Risk of Hospitalization for Pneumonia in Italian Adults from 2010 to 2019: Scientific Evidence for a Call to Action. Vaccines, 11.","DOI":"10.3390\/vaccines11010187"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/j.cmi.2023.04.006","article-title":"Effect of the 23-Valent Pneumococcal Polysaccharide Vaccine on the Incidence of Hospitalization with Pneumonia in Adults Aged \u226565 Years: Retrospective Cohort Study Using a Population-Based Database in Japan","volume":"29","author":"Yamana","year":"2023","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4121","DOI":"10.1016\/j.vaccine.2023.05.040","article-title":"A Retrospective Cohort Study Investigating the Comparative Effectiveness of Pneumococcal Vaccines against Hospitalisation with Otitis Media and Pneumonia in New Zealand","volume":"41","author":"Paynter","year":"2023","journal-title":"Vaccine"}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/11\/8\/1324\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:26:08Z","timestamp":1760127968000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/11\/8\/1324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,4]]},"references-count":28,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["vaccines11081324"],"URL":"https:\/\/doi.org\/10.3390\/vaccines11081324","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,4]]}}}