The association between asthma and invasive pneumococcal disease: A nationwide study in Korea

The purpose of this study was to investigate the association between asthma and invasivepneumococcal disease (IPD) in Korea. A retrospective population-based cohort study wasconducted using the Korean Health Insurance Review and Assessment database 2010-2011.The subjects included 935,106 (2010) and 952,295 (2011), of whom 398 (2010) and 428(2011) patients with IPD were identified. There was significant difference in the prevalenceof IPD in patients with and without asthma (0.07% vs. 0.02% in 2010 and 0.08% vs.0.01% in 2011; P < 0.001). After adjusting for age and gender, patients with asthmashowed over a three-fold increased risk of IPD compared with patients without asthma(adjusted odds ratio [aOR] 3.90, 95% confidence interval [CI] 3.02-5.03 in 2010 / aOR,5.44; 95% CI, 4.10-7.22 in 2011; P < 0.001). These findings were also significant inchildren (aOR, 2.08; 95% CI, 1.25-3.45 in 2010; P = 0.005 / aOR, 3.26; 95% CI,1.74-6.11 in 2011; P < 0.001). Although diabetes mellitus was also significantly associatedwith IPD, relatively low ORs compared with those of asthma were noted (aOR, 1.85; 95%CI, 1.35-2.54 in 2010 / aOR, 2.40; 95% CI, 1.78-3.24 in 2011; P < 0.001). Both childrenand adults with asthma are at increased risk of developing IPD.