在结合疫苗时代，侵袭性肺炎球菌病的持续减少。

Sustained reductions in invasive pneumococcal disease in the era of conjugate vaccine.

机构信息

Division of Bacterial Diseases and Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

出版信息

J Infect Dis. 2010 Jan 1;201(1):32-41. doi: 10.1086/648593.

DOI:10.1086/648593

PMID:19947881

Abstract

BACKGROUND

Changes in invasive pneumococcal disease (IPD) incidence were evaluated after 7 years of 7-valent pneumococcal conjugate vaccine (PCV7) use in US children.

METHODS

Laboratory-confirmed IPD cases were identified during 1998-2007 by 8 active population-based surveillance sites. We compared overall, age group-specific, syndrome-specific, and serotype group-specific IPD incidence in 2007 with that in 1998-1999 (before PCV7) and assessed potential serotype coverage of new conjugate vaccine formulations.

RESULTS

Overall and PCV7-type IPD incidence declined by 45% (from 24.4 to 13.5 cases per 100,000 population) and 94% (from 15.5 to 1.0 cases per 100,000 population), respectively (P< .01 all age groups). The incidence of IPD caused by serotype 19A and other non-PCV7 types increased from 0.8 to 2.7 cases per 100,000 population and from 6.1 to 7.9 cases per 100,000 population, respectively (P< .01 for all age groups). The rates of meningitis and invasive pneumonia caused by non-PCV7 types increased for all age groups (P< .05), whereas the rates of primary bacteremia caused by these serotypes did not change. In 2006-2007, PCV7 types caused 2% of IPD cases, and the 6 additional serotypes included in an investigational 13-valent conjugate vaccine caused 63% of IPD cases among children <5 years-old.

CONCLUSIONS

Dramatic reductions in IPD after PCV7 introduction in the United States remain evident 7 years later. IPD rates caused by serotype 19A and other non-PCV7 types have increased but remain low relative to decreases in PCV7-type IPD.

摘要

背景

在美国儿童中使用 7 价肺炎球菌结合疫苗（PCV7）7 年后，评估了侵袭性肺炎球菌病（IPD）发病率的变化。

方法

1998-2007 年，通过 8 个主动人群监测点确定实验室确诊的 IPD 病例。我们比较了 2007 年与 1998-1999 年（PCV7 之前）的总发病率、年龄组特异性、综合征特异性和血清型组特异性 IPD 发病率，并评估了新的结合疫苗制剂的潜在血清型覆盖率。

结果

总发病率和 PCV7 型 IPD 发病率分别下降了 45%（从每 100,000 人 24.4 例降至 13.5 例）和 94%（从每 100,000 人 15.5 例降至 1.0 例）（所有年龄组 P<0.01）。血清型 19A 和其他非 PCV7 型引起的 IPD 发病率分别从每 100,000 人 0.8 例增至 2.7 例和从每 100,000 人 6.1 例增至 7.9 例（所有年龄组 P<0.01）。所有年龄组非 PCV7 型引起的脑膜炎和侵袭性肺炎的发生率均升高（P<0.05），而这些血清型引起的原发性菌血症发生率没有变化。2006-2007 年，PCV7 型引起的 IPD 病例占 2%，在研究的 13 价结合疫苗中包含的 6 种额外血清型引起的 5 岁以下儿童 IPD 病例占 63%。