Shouval Dror S, Greenberg David, Givon-Lavi Noga, Porat Nurith, Dagan Ron
Pediatric Infectious Disease Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Pediatr Infect Dis J. 2009 Apr;28(4):277-82. doi: 10.1097/INF.0b013e31818e0e2e.
: Since the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in the United States, the need for additional serotype coverage has become clear. Our objective was to assess the potential serotype coverage of PCV7 and of the 2 experimental conjugate vaccines, 10-valent (PCV10) and 13-valent (PCV13), against invasive pneumococcal disease (IPD), acute otitis media (AOM), acute conjunctivitis (AC), and pneumococcal carriage in southern Israel, where PCV7 had not yet been introduced at the time of the study.
: Data on isolates were obtained prospectively from children <36 months during 2000-2004. The potential coverage of the PCVs was calculated and analyzed separately for antibiotic-resistant strains.
: A total of 5497 isolates were collected: 189 from blood or cerebrospinal fluid, 3197 from middle ear fluid, 348 from the conjunctiva, and 1763 from the nasopharynx of healthy children. The serotype coverage of PCV7 for IPD, AOM, AC, and carriage was 44%, 54%, 37%, and 46%, respectively. Serotypes included in PCV7 caused 47 IPD cases per 100,000 children <3 years (54 per 100,000 if serotype 6A is included). PCV10 extended mainly the coverage of IPD, while addition of serotypes 6A and 19A to PCV13 increased the coverage substantially in all entities (84%, 79%, 54%, and 67% in IPD, AOM, AC, and carriage, respectively). PCV13 could prevent >90% of penicillin-, macrolide-, and multidrug-resistant strains associated with IPD and AOM.
: PCV7 can substantially decrease pneumococcal disease and carriage in Israel, but PCV10 and PCV13 have a significant added benefit. Moreover, PCV13 has an important potential added benefit over PCV7 and PCV10 in reducing disease by drug-resistant Streptococcus pneumoniae.
自美国引入7价肺炎球菌结合疫苗（PCV7）以来，增加血清型覆盖范围的必要性已变得明确。我们的目标是评估PCV7以及两种实验性结合疫苗10价（PCV10）和13价（PCV13）对侵袭性肺炎球菌疾病（IPD）、急性中耳炎（AOM）、急性结膜炎（AC）以及在以色列南部肺炎球菌携带情况的潜在血清型覆盖范围，在研究时该地尚未引入PCV7。
前瞻性地收集2000 - 2004年期间36个月以下儿童的分离株数据。分别计算并分析了PCV对耐药菌株的潜在覆盖范围。
共收集到5497株分离株：189株来自血液或脑脊液，3197株来自中耳液，348株来自结膜，1763株来自健康儿童的鼻咽部。PCV7对IPD、AOM、AC和携带的血清型覆盖范围分别为44%、54%、37%和46%。PCV7包含的血清型导致每10万名3岁以下儿童中有47例IPD病例（如果包括6A血清型则为每10万名中有54例）。PCV10主要扩大了IPD的覆盖范围，而PCV13中加入6A和19A血清型后在所有疾病类型中的覆盖范围大幅增加（IPD、AOM、AC和携带分别为84%、79%、54%和67%）。PCV13可预防与IPD和AOM相关的90%以上的青霉素、大环内酯类和多重耐药菌株。
PCV7可大幅降低以色列的肺炎球菌疾病和携带率，但PCV10和PCV13有显著的额外益处。此外，在减少耐青霉素肺炎链球菌引起的疾病方面，PCV13相对于PCV7和PCV10具有重要的潜在额外益处。
