Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital, 5 Fu-Hsin Street, Kwei-Shan Hsiang, Taoyuan, Taiwan.
Vaccine. 2010 Nov 10;28(48):7589-605. doi: 10.1016/j.vaccine.2010.07.053. Epub 2010 Aug 1.
Invasive pneumococcal disease (IPD) burden is significant in the Asia-Pacific region. This review describes the epidemiology and Streptococcus pneumoniae (SP) serotype distribution of IPD in children in the Asia-Pacific region from studies published from 1999 to 2010. IPD incidence varies widely in Asia-Pacific countries depending on the method of surveillance, the population studied, and the time period. Incidences are highest for younger children, with rates near 100-200 cases per 100,000 children aged <1 or 2 years. Incidences of preventable disease are estimated to be 6-200 cases per 100,000. Heptavalent pneumococcal conjugate vaccine (PCV7) serotype coverage shows a very wide range over the Asia-Pacific region. Ten countries have high vaccine serotype coverage (>70%), and six countries have low vaccine serotype coverage (<50%). The majority of SP serotypes in children with IPD in most countries in the Asia-Pacific region are susceptible to penicillin (intermediate and resistant <50%); a few countries have SP serotypes with high level resistance to penicillin (intermediate and resistant >50%). Japan, Taiwan, and Thailand have high PCV7 serotype coverage. Countries with low pneumococcal resistance to antimicrobials have shown increasingly higher nonsusceptibility with time. National vaccination programmes that include PCV7, 10-valent pneumococcal conjugate vaccine (PCV), or 13-valent PCV would significantly affect IPD burden in children aged <5 years in the Asia-Pacific region, as well as the burden of penicillin-nonsusceptible IPD.
在亚太地区，侵袭性肺炎球菌病（IPD）的负担很重。本综述描述了 1999 年至 2010 年期间在亚太地区发表的研究中儿童 IPD 的流行病学和肺炎链球菌（SP）血清型分布。亚太国家的 IPD 发病率因监测方法、研究人群和时间不同而差异很大。发病率在年幼儿童中最高，接近每 10 万名年龄<1 或 2 岁的儿童中有 100-200 例。可预防疾病的发病率估计为每 10 万人中有 6-200 例。七价肺炎球菌结合疫苗（PCV7）血清型覆盖率在亚太地区差异很大。十个国家的疫苗血清型覆盖率很高（>70%），六个国家的疫苗血清型覆盖率较低（<50%）。亚太地区大多数国家儿童 IPD 中 SP 血清型对青霉素敏感（中介和耐药率<50%）；少数国家的 SP 血清型对青霉素具有高水平耐药性（中介和耐药率>50%）。日本、中国台湾和泰国的 PCV7 血清型覆盖率很高。随着时间的推移，对抗菌药物的肺炎球菌耐药率较低的国家显示出越来越高的非敏感性。包括 PCV7、10 价肺炎球菌结合疫苗（PCV）或 13 价 PCV 的国家免疫规划将显著影响亚太地区<5 岁儿童的 IPD 负担，以及青霉素不敏感 IPD 的负担。
