McGee Lesley
Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA.
Curr Opin Microbiol. 2007 Oct;10(5):473-8. doi: 10.1016/j.mib.2007.08.008. Epub 2007 Oct 23.
Pneumococcal conjugate vaccine is not only effective against invasive and non-invasive disease in all ages but also has a significant impact on antibiotic-resistant infections since a number of resistant serotypes are targeted by the vaccine. Surveillance studies in the post-licensure years have shown an increase in non-vaccine types both in carriage and disease isolates. There appears to be an increasing trend in antimicrobial resistance among these non-vaccine types, especially in serotype 19A. The impact these non-vaccine types will have on disease remains to be seen, but clearly continued efforts at characterizing the pneumococcal population are essential for future surveillance. Although expanded vaccine formulations with efficacy against a wider range of serotypes will be useful, reduction of drug-resistant Streptococcus pneumoniae will require a combination of the conjugate vaccine and a reduction in antimicrobial use.
肺炎球菌结合疫苗不仅对各年龄段的侵袭性和非侵袭性疾病有效，而且由于该疫苗针对多种耐药血清型，因此对耐药感染也有显著影响。在疫苗获批后的几年里进行的监测研究表明，无论是在携带菌株还是疾病分离株中，非疫苗型菌株的数量都有所增加。这些非疫苗型菌株的耐药性似乎呈上升趋势，尤其是19A血清型。这些非疫苗型菌株对疾病的影响还有待观察，但显然持续努力对肺炎球菌群体进行特征分析对于未来的监测至关重要。虽然扩大疫苗配方以对抗更广泛的血清型会很有用，但减少耐药肺炎链球菌需要结合疫苗接种和减少抗菌药物的使用。
