Ahonkhai V I, Lukacs L J, Jonas L C, Matthews H, Vella P P, Ellis R W, Staub J M, Dolan K T, Rusk C M, Calandra G B
Merck Sharp & Dohme Research Laboratories, West Point, PA 19486.
Pediatrics. 1990 Apr;85(4 Pt 2):676-81.
Although systemic infections caused by Haemophilus influenzae type b occur worldwide, detailed epidemiologic data are available in but a few countries. The public health impact of morbidity, mortality, and serious sequelae from disease caused by H influenzae type b has stimulated the search for control strategies. In the United States now, active immunoprophylaxis is largely favored over treatment of prophylaxis with antibiotics. This preference stems from three major observations: that high mortality and morbidity persist despite the availability of potent antimicrobial agents, that antibiotic-resistant strains of H influenzae type b have emerged, and that implementation of antimicrobial prophylaxis on a large scale has been unsatisfactory. Moreover, universal vaccination has been projected as offering a higher economic benefit than other control strategies. A matter of more proximate importance, however, is the search for H influenzae type b vaccines that will confer protection to all age groups, including infants younger than 18 months of age and subpopulations specifically at risk for invasive disease caused by H influenzae type b. Haemophilus b conjugate vaccine (meningococcal protein conjugate), PedvaxHIB (PRP-OMPC), is a conjugate H influenzae type b vaccine developed at Merck Sharp & Dohme Research Laboratories that now is undergoing extensive clinical evaluation to assess its prospects for disease control when first administered in early infancy. This is an interim report of results obtained in studies conducted in diverse locations throughout the United States.
虽然b型流感嗜血杆菌引起的全身性感染在全球范围内都有发生,但只有少数国家有详细的流行病学数据。b型流感嗜血杆菌所致疾病的发病率、死亡率及严重后遗症对公共卫生造成的影响,促使人们寻找控制策略。在美国,目前积极的免疫预防在很大程度上比用抗生素进行预防性治疗更受青睐。这种偏好源于三个主要观察结果:尽管有强效抗菌药物,但高死亡率和高发病率仍然存在;b型流感嗜血杆菌的耐药菌株已经出现;大规模实施抗菌预防并不理想。此外,预计普遍接种疫苗比其他控制策略能带来更高的经济效益。然而,更紧迫的重要问题是寻找能为所有年龄组提供保护的b型流感嗜血杆菌疫苗,包括18个月以下的婴儿以及特别易患b型流感嗜血杆菌所致侵袭性疾病的亚人群。b型流感嗜血杆菌结合疫苗(脑膜炎球菌蛋白结合疫苗),即PedvaxHIB(PRP - OMPC),是默克夏普&多贺美研究实验室研发的一种b型流感嗜血杆菌结合疫苗,目前正在进行广泛的临床评估,以评估其在婴儿早期首次接种时对疾病控制的前景。这是在美国各地不同地点进行的研究中所获结果的一份中期报告。