Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya8358810.26442/00403660.2022.11.201932Research ArticleImpact of vaccination with pneumococcal vaccines on recurrent pneumonia in patients with chronic obstructive pulmonary diseaseIgnatovaGalina L.ant-vn@yandex.ruhttps://orcid.org/0000-0002-0877-6554AntonovVladimir N.ant-vn@yandex.ruhttps://orcid.org/0000-0002-3531-3491South Ural State Medical University2612202294111257126123102021Copyright © 2022, Consilium Medicum2022<p><strong>Background. </strong>Community-acquired pneumonia (САР) and chronic obstructive pulmonary disease (COPD) are among the main causes of mortality worldwide, and, in addition, they also lead to great economic losses for the health system of all countries. Currently, there is an increase in cases of recurrent pneumonia, both in the general population and, in particular, in patients with COPD. One of the most important risk factors for the development of pneumonia is the previous episode of САР. Potential risk factors for recurrent pneumonia are concomitant diseases such as heart failure, COPD, diabetes mellitus, neurological disorders, swallowing dysfunction, immune deficiency.</p>
<p><strong>Aim. </strong>To conduct a retrospective analysis of the effect of vaccine prophylaxis with conjugated pneumococcal vaccine (PCV13) and polysaccharide pneumococcal vaccine (PPV23) on the risk of recurrent pneumonia in patients with COPD.</p>
<p><strong>Materials and methods. </strong>A total of 302 male patients were included in the retrospective study. When analyzing the data, the fact of the development of pneumonia of any etiology during the 5th observation period was taken into account. For the recurrence of pneumonia, more than two episodes of CAP were taken during the year. 13-valent conjugated pneumococcal vaccine Prevenar-13 and 23-valent polysaccharide vaccine Pneumo23 were used for vaccine prophylaxis. The relative risk of the event was calculated. A 95% confidence interval was used.</p>
<p><strong>Results and conclusion. </strong>A retrospective analysis showed that, firstly, CAP is a fairly frequent complication of COPD: initially, the average percentage of cases of САР was 19.3%. Secondly, the risk of developing repeated episodes of pneumonia remains quite high in unvaccinated patients and tends to increase within 5 years: from 17 to 22%. Thirdly, the pneumococcal vaccines used have different effects on the risk of recurrent pneumonia in patients with COPD, a significant decrease in the number of recurrent pneumonia is observed only with the use of conjugated vaccines.</p>сhronic obstructive pulmonary diseaserecurrent pneumoniavaccinoprophylaxisconjugated pneumococcal vaccineхроническая обструктивная болезнь легкихповторные пневмониивакцинопрофилактикаконъюгированная пневмококковая вакцина[Williams NP, Coombs NA, Johnson MJ, et al. Seasonality, risk factors and burden of community-acquired pneumonia in COPD patients: a population database study using linked health care records. Int J Chron Obstruct Pulmon Dis. 2017;12:313-22. DOI:10.2147/COPD.S121389][Millett ER, Quint JK, Smeeth L, et al. Incidence of community-acquired lower respiratory tract infections and pneumonia among older adults in the United Kingdom: a population-based study. PLoS One. 2013;8(9):e75131. DOI:10.1371/journal.pone.0075131][Хроническая обструктивная болезнь легких. Клинические рекомендации Министерства здравоохранения Российской Федерации, 2021 г. Режим доступа: https://cr.minzdrav.gov.ru/schema/603_2. Ссылка активна на 29.09.2022 [Khronicheskaia obstruktivnaia bolezn' legkikh. Klinicheskie rekomendatsii Ministerstva zdravookhraneniia Rossiiskoi Federatsii, 2021 g. Available at: https://cr.minzdrav.gov.ru/schema/603_2. Accessed: 29.09.2022 (in Russian)].][Chuchalin AG, Khaltaev N, Antonov NS, et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int J COPD. 2014;12:963-74. DOI:10.2147/copd.s67283][Niu Y, Xing Y, Li J, et al. Effect of Community-Acquired Pneumonia on Acute Exacerbation of Chronic Obstructive Pulmonary Disease, COPD. J Chron Obstruct Pulmon Dis. 2021;18(4):417-24. DOI:10.1080/15412555.2021.1950664][Garcia-Vidal C, Carratalà J, Fernández-Sabé N, et al. Aetiology of, and risk factors for, recurrent community-acquired pneumonia. Clin Microbiol Infect. 2009;15(11):1033-8. DOI:10.1111/j.1469-0691.2009.02918.x][Johnstone J, Eurich DT, Majumdar SR, et al. Long-term morbidity and mortality after hospitalization with community-acquired pneumonia: a population-based cohort study. Medicine (Baltimore). 2008;87:329-34. DOI:10.1097/md.0b013e318190f444][Ekdahl K, Braconier JH, Rollof J. Recurrent Pneumonia: A Review of 90 Adult Patients. Scand J Infect Dis. 1992;24(1):71-6. DOI:10.3109/00365549209048403][Dang TT, Eurich DT, Weir DL, et al. Rates and Risk Factors for Recurrent Pneumonia in Patients Hospitalized With Community-Acquired Pneumonia: Population-Based Prospective Cohort Study With 5 Years of Follow-up. Clin Infect Dis. 2014;59(1):74-80. DOI:10.1093/cid/ciu247][Чучалин А.Г., Брико Н.И., Авдеев С.Н., и др. Федеральные клинические рекомендации по вакцинопрофилактике пневмококковой инфекции у взрослых. Пульмонология. 2019;29(1):19-34 [Chuchalin AG, Briko NI, Avdeev SN, et al. Federal Clinical Guidelines on Preventive Vaccination Against Pneumococcal infections in Adults. Pulmonologiya. 2019;29(1):19-34 (in Russian)]. DOI:10.18093/0869-0189-2019-29-1-19-34][Драпкина О.М., Брико Н.И., Костинов М.П., и др. Иммунизация взрослых. Методические рекомендации. М.: ФГБУ «НМИЦ ТПМ» Минздрава России, 2020 [Drapkina OM, Briko NI, Кostinov MP, et al. Immunizatsiia vzroslykh. Metodicheskie rekomendatsii. M.: FSBI “NMIC TPM” of the Ministry of Health of Russia, 2020 (in Russian)].]