13 价肺炎球菌结合疫苗对急性中耳炎儿童鼻咽携带肺炎球菌的影响。
Impact of 13-valent pneumococcal conjugate vaccine on pneumococcal nasopharyngeal carriage in children with acute otitis media.
机构信息
ACTIV (Association Clinique et Thérapeutique Infantile du Val de Marne), Paris, France.
出版信息
Pediatr Infect Dis J. 2012 Mar;31(3):297-301. doi: 10.1097/INF.0b013e318247ef84.
BACKGROUND
13-valent pneumococcal conjugate vaccine (PCV13) licensure was based on the immune response (enzyme-linked immunosorbent assay and opsonophagocytic assay) compared with PCV7. National surveillance program of pneumococcal nasopharyngeal (PNP) carriage in children with acute otitis media (AOM) was set up in 2001 when PCV7 was introduced in France and continues to the present. This program was used in 2010-2011 to assess the effect of the implementation of PCV13 on PNP carriage in young children with AOM.
METHODS
Between October 2010 and March 2011, 58 pediatricians obtained 943 nasopharyngeal swabs from children (6 to 24 months of age) with AOM. The swabs were sent for analysis to the French National Reference Centre for Pneumococci. Demographics, medical history, and physical examination findings were recorded.
RESULTS
Among 943 children enrolled (mean age, 13.4 months), 651 had received at least 1 dose of PCV13 and 285 received PCV7 only. Among PCV13-vaccinated children, overall PNP carriage and carriage of serotypes not in PCV7 were significantly lower as compared with children exclusively vaccinated with PCV7 (53.9% vs. 64.6%, P = 0.002 and 9.5% vs. 20.7%, P < 0.0001, respectively). For serotypes 19A, 7F, and 6C, the carriage rates were also significantly lower in PCV13-vaccinated patients than in patients only vaccinated by PCV7: 7.5% versus 15.4%, P < 0.001, 0.5% versus 2.8%, P = 0.002, and 3.7% versus 8.4%, P = 0.003, respectively.
CONCLUSION
In young children (<2 years) with AOM, this study suggests that PCV13 has an impact on overall PNP carriage, as well as on serotypes 19A, 7F, and 6C.
背景
13 价肺炎球菌结合疫苗（PCV13）的许可基于免疫反应（酶联免疫吸附试验和调理吞噬试验）与 PCV7 进行比较。2001 年法国引入 PCV7 时建立了儿童急性中耳炎（AOM）中肺炎球菌鼻咽（PNP）携带的国家监测计划，并持续至今。该计划于 2010-2011 年用于评估 PCV13 实施对 AOM 幼儿 PNP 携带的影响。
方法
2010 年 10 月至 2011 年 3 月期间，58 名儿科医生从患有 AOM 的儿童（6 至 24 个月龄）中获得了 943 个鼻咽拭子。这些拭子被送往法国国家肺炎球菌参考中心进行分析。记录了人口统计学、病史和体检结果。
结果
在纳入的 943 名儿童中（平均年龄 13.4 个月），651 名儿童至少接受了 1 剂 PCV13 疫苗接种，285 名儿童仅接受了 PCV7 疫苗接种。与仅接受 PCV7 疫苗接种的儿童相比，PCV13 疫苗接种儿童的总体 PNP 携带率和未包含在 PCV7 中的血清型携带率显著降低（53.9%对 64.6%，P=0.002 和 9.5%对 20.7%，P<0.0001）。对于血清型 19A、7F 和 6C，PCV13 疫苗接种组的携带率也明显低于仅接受 PCV7 疫苗接种的患者：7.5%对 15.4%，P<0.001，0.5%对 2.8%，P=0.002 和 3.7%对 8.4%，P=0.003。
结论
在患有 AOM 的幼儿（<2 岁）中，本研究表明 PCV13 对总体 PNP 携带以及血清型 19A、7F 和 6C 具有影响。
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