Motlová J, Benes C, Kríová P
Státní zdravotní ústav, Praha.
Epidemiol Mikrobiol Imunol. 2008 Feb;57(1):14-21.
To assess the incidence of invasive pneumococcal disease and coverage of the causative serotypes by pneumococcal vaccines in the Czech Republic.
The incidence and fatality rates of reported cases of pneumococcal meningitis (EPIDAT) in 1997-2006 are analyzed. In addition, the data of the National Reference Laboratory for Streptococci and Enterococci from 2000-2006 are presented. The incidence of invasive pneumococcal disease was calculated for the catchment population of the collaborating laboratories. Pneumococcal typing was performed in the National Reference Laboratory. The percentages of pneumococcal serotypes isolated from invasive disease in 2000-2006 and included in the pneumococcal vaccines were calculated.
The incidence of invasive pneumococcal disease ranged from 2.30 to 4.28/100000 population. The age-specific incidence of invasive pneumococcal disease in 2000-2006 was the highest in the lowest age groups 0-11 months (15.75/100000) and 1-4 years (8.22/100000), followed by the age group of 65 years and older (7.3/100000). The total fatality rate of pneumococcal meningitis in 1997-2006 was 13.7%. The highest age-specific fatality rate was recorded in 65-year olds and over (24%). In the age group 0-11 months, the coverage of pneumococcal serotypes is 66% by the 7-valent conjugate vaccine, 76% by the 10-valent conjugate vaccine and 82% by thel3-valent conjugate vaccine. In the age group 1-4 years, the respective rates are 65.1%, 76.4% and 85.8%. The coverage of serotypes by conjugate vaccines is higher in the youngest age groups (0-11 months and 1-4 years) compared to adults (40-64 years and 65 years and older).
Based on laboratory data, the incidence of invasive pneumococcal disease in the Czech Republic in 2000-2006 is comparable with the rates reported in other European countries. The highest incidence rates were observed in the youngest age groups. The distribution of serotypes causing invasive pneumococcal disease differs between children and adults. The coverage of serotypes by conjugate pneumococcal vaccines is higher in children (66-65%) compared to adults (34-65%). It is desirable to launch a nationwide programme of surveillance of invasive pneumococcal disease. Furthermore, it is recommended that a conjugate pneumococcal vaccine should be included in the children's immunization schedule.
评估捷克共和国侵袭性肺炎球菌疾病的发病率以及肺炎球菌疫苗对致病血清型的覆盖情况。
分析1997 - 2006年报告的肺炎球菌脑膜炎病例（EPIDAT）的发病率和死亡率。此外，还提供了2000 - 2006年国家链球菌和肠球菌参考实验室的数据。计算协作实验室集水区人群的侵袭性肺炎球菌疾病发病率。在国家参考实验室进行肺炎球菌分型。计算2000 - 2006年从侵袭性疾病中分离出并包含在肺炎球菌疫苗中的肺炎球菌血清型百分比。
侵袭性肺炎球菌疾病的发病率为每10万人2.30至4.28例。2000 - 2006年侵袭性肺炎球菌疾病的年龄特异性发病率在最低年龄组0 - 11个月（每10万人15.75例）和1 - 4岁（每10万人8.22例）最高，其次是65岁及以上年龄组（每10万人7.3例）。1997 - 2006年肺炎球菌脑膜炎的总死亡率为13.7%。最高年龄特异性死亡率记录在65岁及以上人群（24%）。在0 - 11个月年龄组，7价结合疫苗对肺炎球菌血清型的覆盖率为66%，10价结合疫苗为76%，13价结合疫苗为82%。在1 - 4岁年龄组，相应比例分别为65.1%、76.4%和85.8%。与成人（40 - 64岁和65岁及以上）相比，结合疫苗对血清型的覆盖率在最年轻年龄组（0 - 11个月和1 - 4岁）更高。
根据实验室数据，2000 - 2006年捷克共和国侵袭性肺炎球菌疾病的发病率与其他欧洲国家报告的发病率相当。最高发病率出现在最年轻年龄组。引起侵袭性肺炎球菌疾病的血清型分布在儿童和成人之间有所不同。与成人（34 - 65%）相比，结合肺炎球菌疫苗对儿童血清型的覆盖率更高（66 - 65%）。开展全国性的侵袭性肺炎球菌疾病监测计划是可取的。此外，建议将结合肺炎球菌疫苗纳入儿童免疫接种计划。
