Bekri H, Cohen R, Varon E, Madhi F, Gire R, Guillot F, Delacourt C
Service de pédiatrie, centre hospitalier intercommunal, 40, allée de la Source, 94190 Villeneuve-Saint-Georges, France.
Arch Pediatr. 2007 Mar;14(3):239-43. doi: 10.1016/j.arcped.2006.12.010. Epub 2007 Feb 2.
It has been suggested that the incidence of childhood empyema have increased during the last years in France without clear explanation. Streptococcus pneumoniae is responsible for the vast majority of bacteriological documented cases. Potential prevention of pleural empyemas by the heptavalent pneumococcal conjugate vaccine is dependent on adequation between specific pneumococcal serogroups present in vaccine and those responsible for empyemas.
We retrospectively collected cases of pleural empyemas registered at the National Reference Center for pneumococci (December 2002 to February 2004). Thirty children, aged 4.1+/-3.3 (SD) years, were included.
Ten specific serogroups were identified: 1, 3, 5, 6B, 7F, 9V, 14, 18C, 19A, and 23F. Serogroups 19A and 1 were the 2 dominant serogroups and represented 50% of cases. All children infected with serotype 19A were younger than 5 years, whereas serotype 1 was identified in 80% of empyemas in children older than 5 years. Among the 30 patients enrolled, 20 (69%) were infected with serotypes not included in the conjugate vaccine.
These results thus limit the potential impact of the heptavalent pneumococcal conjugate vaccine on the frequency of pleural empyemas in children.
有人提出,过去几年法国儿童脓胸的发病率有所上升,但原因不明。肺炎链球菌是绝大多数有细菌学记录病例的致病菌。七价肺炎球菌结合疫苗对胸膜脓胸的潜在预防作用取决于疫苗中特定肺炎球菌血清型与导致脓胸的血清型之间的匹配程度。
我们回顾性收集了在国家肺炎球菌参考中心登记的胸膜脓胸病例(2002年12月至2004年2月)。纳入了30名年龄为4.1±3.3(标准差)岁的儿童。
鉴定出10种特定血清型:1、3、5、6B、7F、9V、14、18C、19A和23F。血清型19A和1是两个主要血清型,占病例的50%。所有感染19A血清型的儿童均小于5岁,而血清型1在5岁以上儿童的脓胸病例中占80%。在纳入的30例患者中,20例(69%)感染了结合疫苗未包含的血清型。
因此,这些结果限制了七价肺炎球菌结合疫苗对儿童胸膜脓胸发生率的潜在影响。