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加拿大魁北克省实施肺炎球菌结合疫苗计划后的肺炎情况。

Pneumonia after implementation of the pneumococcal conjugate vaccine program in the province of Quebec, Canada.

作者信息

De Wals Philippe, Robin Elodie, Fortin Elise, Thibeault Roseline, Ouakki Manale, Douville-Fradet Monique

机构信息

Department of Social and Preventive Medicine, Laval University, Quebec City, Canada.

出版信息

Pediatr Infect Dis J. 2008 Nov;27(11):963-8. doi: 10.1097/INF.0b013e31817cf76f.

Abstract

BACKGROUND

In Canada, a pneumococcal conjugate vaccine was licensed in 2001, and in the province of Quebec, a publicly-funded program was implemented for high-risk children in 2002, using a 4-dose schedule, and for all children in 2004, using a 3-dose schedule.

OBJECTIVES

To describe the epidemiology of hospitalized pneumonia in the population aged <5 years.

METHODOLOGY

Hospital discharge records with a main diagnosis of pneumonia, pleurisy, or empyema were analyzed regarding monthly frequencies by diagnostic categories, duration of stay, proportion of cases admitted to the intensive care unit, and case fatality.

RESULTS

Lobar pneumonia represented 32% of 25,319 all-cause pneumonia admissions during the period April 1997 to March 2006. Beginning in the spring of 2004, there was a marked decrease in the frequency of lobar pneumonia, whereas unspecified pneumonia tended to increase to a lesser extent. Compared with the pre-pneumococcal conjugate vaccine period, admissions for all-causes pneumonia decreased by 13% after program implementation and there was no increase in empyema cases.

CONCLUSIONS

Results are reassuring as to the effectiveness of the pneumococcal vaccination program in Quebec.

摘要

背景

2001年,一种肺炎球菌结合疫苗在加拿大获得许可,2002年,魁北克省针对高危儿童实施了一项公共资助项目,采用4剂接种程序,2004年,针对所有儿童实施该项目,采用3剂接种程序。

目的

描述5岁以下人群中住院肺炎的流行病学特征。

方法

分析主要诊断为肺炎、胸膜炎或脓胸的医院出院记录,内容包括按诊断类别划分的每月发病频率、住院时间、入住重症监护病房的病例比例以及病死率。

结果

在1997年4月至2006年3月期间,大叶性肺炎占25319例全因肺炎入院病例的32%。从2004年春季开始,大叶性肺炎的发病频率显著下降,而未明确的肺炎在较小程度上呈上升趋势。与肺炎球菌结合疫苗接种前时期相比,项目实施后全因肺炎入院病例减少了13%,脓胸病例没有增加。

结论

魁北克省肺炎球菌疫苗接种项目的有效性令人放心。

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