Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2011 Feb;26(2):184-90. doi: 10.3346/jkms.2011.26.2.184. Epub 2011 Jan 24.
To confirm the effect of 7-valent pneumococcal conjugate vaccine (PCV7), pneumococcal nasopharyngeal (NP) carriage was compared between vaccinated (3 + 1 doses PCV7) and non-vaccinated children. Vaccinated subjects were recruited from highly vaccinated regions (≥ 60%), Seoul and Incheon whereas control subjects were recruited from Jeju Island where vaccination rates are low (< 15%). NP swabs were obtained from 400 children aged 18-59 months. Serotype and antibiotic susceptibility was analyzed. Pneumococcal carriage rate was 18.0% (36/200) and 31.5% (63/200) for the vaccinated and control group, respectively. Among those vaccinated, 41.7% (15/36) of the serotypes were vaccine-related type (VRT: 6A, 6C, 19A) with the most common serotype 6C. The next common type was non-typable/non-capsule 30.6% (11/36) followed by non-vaccine type 16.7% (6/36) and vaccine type (VT) serotypes were found in only 11.1% (4/36). In contrast, 52.4% (33/63) of the isolates in the control group were VT. Resistance rates for penicillin and erythromycin were lower in the vaccine group (vaccine vs control; penicillin 45.2% vs 71.4%, erythromycin 74.2% vs 90.5%, P < 0.05). Multi-drug resistance was also lower in vaccinated subjects (vaccine vs control; 45.2% vs 69.8%, P < 0.05). PCV7 reduces carriage in VT which leads to replacement of pneumococci by antibiotic susceptible VRT or non-vaccine type strains.
为了确认 7 价肺炎球菌结合疫苗（PCV7）的效果，比较了接种（3+1 剂 PCV7）和未接种儿童的鼻咽（NP）带菌率。接种组从高接种率地区（≥60%）首尔和仁川招募，对照组从接种率较低（<15%）的济州岛招募。从 400 名 18-59 个月的儿童中采集 NP 拭子。分析血清型和抗生素敏感性。接种组和对照组的肺炎球菌带菌率分别为 18.0%（36/200）和 31.5%（63/200）。在接种者中，41.7%（15/36）的血清型为疫苗相关型（VRT：6A、6C、19A），最常见的血清型为 6C。下一个常见的类型是非典型/无荚膜 30.6%（11/36），其次是非疫苗型 16.7%（6/36），疫苗型（VT）血清型仅发现 11.1%（4/36）。相比之下，对照组中 52.4%（33/63）的分离株为 VT。青霉素和红霉素的耐药率在疫苗组较低（疫苗组与对照组相比；青霉素 45.2% vs 71.4%，红霉素 74.2% vs 90.5%，P<0.05）。接种组的多药耐药率也较低（疫苗组与对照组相比；45.2% vs 69.8%，P<0.05）。PCV7 降低了 VT 的带菌率，导致对青霉素敏感的 VRT 或非疫苗型菌株取代肺炎球菌。
