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评估牛接种疫苗预防大肠杆菌 O157:H7 效力的现有信息——系统评价和荟萃分析。

Assessing the existing information on the efficacy of bovine vaccination against Escherichia coli O157:H7--a systematic review and meta-analysis.

机构信息

Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.

出版信息

Zoonoses Public Health. 2013 Jun;60(4):253-68. doi: 10.1111/j.1863-2378.2012.01523.x. Epub 2012 Aug 1.

Abstract

The objective of this study was to conduct a systematic review and meta-analysis to evaluate the existing information on the efficacy of commercial vaccination to reduce the prevalence of Escherichia coli O157:H7 in weaned cattle in beef feedlot finishing systems under commercial conditions. Currently, only two commercial vaccines exist, and thus, only publications reporting the use of vaccines targeting type III secreted proteins and/or siderophore receptor and porin proteins (SRP) were considered relevant. A total of 18 studies reporting 45 comparisons were included in this review. Meta-analyses were conducted variously on (i) pre-harvest outcomes, (ii) at-harvest outcomes and (iii) both pre-harvest and at-harvest outcomes combined. Overall, efficacy of vaccination was consistently observed. Efficacy and homogeneity of the results was demonstrated for the two-dose regimen, allowing us to conclude with confidence that the two-dose approach is efficacious. For pre-harvest outcomes and two-dose regimens, the odds ratios (OR) were 0.53 (95% CI = 0.45-0.62) for the two vaccines combined and 0.49 (95% CI = 0.40-0.60) for vaccine targeting type III secreted proteins. The test for heterogeneity among studies yielded a Q test P = 0.354 for the two vaccines combined and Q test P = 0.269 for the vaccine targeting type III secreted proteins, indicating homogeneity in both cases. For pre- and at-harvest outcomes combined and two-dose regimens, the odds ratios (OR) were 0.52 (95% CI = 0.44-0.61) for the two vaccines combined and 0.45 (95% CI = 0.34-0.60) for vaccine targeting type III secreted proteins. The test for heterogeneity among studies yielded a Q test P = 0.134 for the two vaccines combined indicating homogeneity and Q test P = 0.089 for the vaccine targeting type III secreted proteins indicating heterogeneity. Based on this meta-analysis, bovine vaccination appears to be an effective approach to the pre-harvest control of E. coli O157:H7.

摘要

本研究的目的是进行系统回顾和荟萃分析,以评估在商业条件下商业疫苗对减少牛肉育肥场完成系统中断奶牛大肠杆菌 O157:H7 流行率的现有信息。目前,仅存在两种商业疫苗,因此,仅考虑报告使用针对 III 型分泌蛋白和/或铁载体受体和孔蛋白 (SRP) 的疫苗的出版物。本综述共纳入了 18 项研究,报道了 45 项比较。荟萃分析分别在 (i) 收获前结果、(ii) 收获时结果和 (iii) 收获前和收获时结果组合上进行。总体而言,疫苗接种的效果是一致的。两种疫苗的两剂量方案显示出了有效性和结果的同质性,使我们有信心得出结论,即两剂量方案是有效的。对于收获前结果和两剂量方案,两种疫苗的合并的优势比 (OR) 为 0.53 (95%CI = 0.45-0.62),针对 III 型分泌蛋白的疫苗为 0.49 (95%CI = 0.40-0.60)。对研究之间异质性的检验得出,两种疫苗合并的 Q 检验 P = 0.354,针对 III 型分泌蛋白的疫苗为 Q 检验 P = 0.269,两种情况下均显示出同质性。对于收获前和收获时结果组合和两剂量方案,两种疫苗的合并的优势比 (OR) 为 0.52 (95%CI = 0.44-0.61),针对 III 型分泌蛋白的疫苗为 0.45 (95%CI = 0.34-0.60)。对研究之间异质性的检验得出,两种疫苗合并的 Q 检验 P = 0.134 表明同质性,针对 III 型分泌蛋白的疫苗为 Q 检验 P = 0.089 表明异质性。基于这项荟萃分析,牛疫苗接种似乎是一种有效的方法,可以在收获前控制大肠杆菌 O157:H7。

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