Watson Michael, Roche Paul, Bayley Kathy, Bell Jan M, Collignon Peter, Gilbert Gwendolyn L, Hogg Geoff, Keil Anthony D, Krause Vicki, Murphy Denise, Smith Helen V, Brown Mitchell, Stylianopoulos Joanne, Turnidge John
The NSW Pneumococcal Reference Laboratory, Department of Microbiology, The Children's Hospital at Westmead, Westmead, New South Wales.
Commun Dis Intell Q Rep. 2004;28(4):455-64.
A comprehensive invasive pneumococcal disease (IPD) laboratory surveillance program was carried out in Australia in 2003. This program provided data on the prevalence of pneumococcal serotypes and antimicrobial resistance. There were 1,995 isolates tested with 34 per cent (683) from children aged less than five years and 27 per cent (535) from the elderly aged more than 65 years. One thousand eight hundred and sixty were isolates from blood, 79 from CSF and 56 from other sterile sites. In young children, 84 per cent of isolates were a serotype and 92 per cent a serogroup in the 7-valent pneumococcal conjugate vaccine (7vPCV). Of penicillin resistant isolates in children less than five years of age 85 per cent and 98 per cent were a serotype and serogroup in the 7vPCV respectively. When the universal 7vPCV vaccine program in young children is introduced in 2005, a proportion of cases of IPD should also be prevented in young adults (estimated reduction of 54 cases annually) and elderly Australians (an estimated reduction of 110 cases annually) as a result of improved herd immunity. Pneumococcal serotypes with higher rates of penicillin resistance (19F, 14 and 6B) were more prevalent in the elderly than in young children. In contrast, erythromycin resistance was more common in children less than five years of age (24%) compared to the elderly (15%). The predominant serotype with erythromycin resistance in Australia was serotype 14 and thus there is likely to be a major reduction in erythromycin resistance as a result of 7vPCV vaccination. Continued surveillance of pneumococcal serotype distribution and antibiotic susceptibility will be essential in order to identify serotype replacement by non-vaccine serotypes and to monitor the overall impact of current and future vaccine programs on invasive pneumococcal disease in Australia, not only in young children but also in other age groups.
2003年，澳大利亚开展了一项全面的侵袭性肺炎球菌疾病（IPD）实验室监测项目。该项目提供了肺炎球菌血清型流行情况及抗菌药物耐药性的数据。共检测了1995株菌株，其中34%（683株）来自5岁以下儿童，27%（535株）来自65岁以上老年人。1860株来自血液，79株来自脑脊液，56株来自其他无菌部位。在幼儿中，84%的分离株属于7价肺炎球菌结合疫苗（7vPCV）中的一种血清型，92%属于一个血清群。5岁以下儿童中对青霉素耐药的分离株，85%属于7vPCV中的一种血清型，98%属于一个血清群。2005年在幼儿中推行通用的7vPCV疫苗项目后，由于群体免疫力提高，预计每年可预防一部分年轻成年人（估计每年减少54例）和澳大利亚老年人（估计每年减少110例）的IPD病例。青霉素耐药率较高的肺炎球菌血清型（19F、14和6B）在老年人中比在幼儿中更普遍。相比之下，红霉素耐药在5岁以下儿童中（24%）比在老年人中（15%）更常见。澳大利亚红霉素耐药的主要血清型是14型，因此7vPCV疫苗接种可能会使红霉素耐药性大幅降低。持续监测肺炎球菌血清型分布和抗生素敏感性对于识别非疫苗血清型导致的血清型替代，以及监测当前和未来疫苗项目对澳大利亚侵袭性肺炎球菌疾病的总体影响至关重要，不仅对幼儿，对其他年龄组也是如此。
