Vestrheim Didrik F, Høiby E Arne, Aaberge Ingeborg S, Caugant Dominique A
Department of Bacteriology and Immunology, Division of Infectious Disease Control, Norwegian Institute of Public Health, Nydalen, Oslo, Norway.
Clin Vaccine Immunol. 2010 Mar;17(3):325-34. doi: 10.1128/CVI.00435-09. Epub 2010 Jan 27.
In July 2006, the seven-valent pneumococcal conjugate vaccine (PCV7) was introduced in Norway with a reduced (2 doses + 1 boost) dose schedule. Post-PCV7 shifts in pneumococcal reservoirs were assessed by two point prevalence studies of nasopharyngeal colonization among children in day care centers, before (2006) and after (2008) widespread use of PCV7. Nasopharyngeal swabs were obtained from 1,213 children, 611 in 2006 and 602 in 2008. A total of 1,102 pneumococcal isolates were recovered. Serotyping, multilocus sequence typing, and antimicrobial drug susceptibility testing were performed on all isolates. Although carriage of PCV7 serotypes decreased among both vaccinated and unvaccinated children, the overall prevalence of pneumococcal carriage remained high (80.4%) after vaccine introduction. The pneumococcal populations were diverse, and in the shift toward non-PCV7 serotypes, expansion of a limited number of established clonal complexes was observed. While non-antimicrobial-susceptible clones persisted among PCV7 serotypes, antimicrobial resistance did not increase among non-PCV7 serotypes. Direct and indirect protection of PCV7 against nasopharyngeal colonization was inferred from an overall decrease in carriage of PCV7 serotypes. No preference was found for nonsusceptible clones among the replacing non-PCV7 serotypes.
2006年7月，七价肺炎球菌结合疫苗（PCV7）在挪威开始使用，采用了减少剂量的接种程序（2剂 + 1剂加强针）。通过对日托中心儿童进行两项关于鼻咽部定植的现况研究，在PCV7广泛使用之前（2006年）和之后（2008年），评估了肺炎球菌储存库在PCV7接种后的变化。从1213名儿童中获取鼻咽拭子，2006年611名，2008年602名。共分离出1102株肺炎球菌。对所有分离株进行了血清分型、多位点序列分型和抗菌药物敏感性测试。尽管接种疫苗和未接种疫苗的儿童中PCV7血清型的携带率均有所下降，但疫苗引入后肺炎球菌携带的总体患病率仍然很高（80.4%）。肺炎球菌群体具有多样性，在向非PCV7血清型转变的过程中，观察到有限数量的已建立克隆复合体出现了扩张。虽然非抗菌药物敏感克隆在PCV7血清型中持续存在，但非PCV7血清型中的抗菌药物耐药性并未增加。从PCV-7血清型携带率的总体下降推断出PCV7对鼻咽部定植的直接和间接保护作用。在替代的非PCV7血清型中未发现对非敏感克隆的偏好。
