Cohen R, Levy C, Bingen E, Bechet S, Derkx V, Werner A, Koskas M, Varon E
Association clinique et thérapeutique infantile du Val-de-Marne (ACTIV), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France.
Arch Pediatr. 2012 Oct;19(10):1132-9. doi: 10.1016/j.arcped.2012.07.013. Epub 2012 Aug 24.
Since 2001 in France, a nasopharyngeal carriage study was set up for children six to 24 months old. Any data are available for older children (25 to 60 months). The aim of this study is to compare the nasopharyngeal carriage in children with acute otitis media (AOM) or healthy between both age groups (6/24 months versus 25/60 months). Moreover, during the study period, the 13-valent pneumococcal conjugate vaccine (PCV13) has replaced PCV7 in June 2010.
From October 2010 to June 2011, 58 pediatricians obtained nasopharyngeal swabs from children 6-60 months with acute otitis media (AOM) or healthy controls, to analyse the carriage of pneumococcus, Haemophilus influenzae, Moraxella catarrhalis, group A streptococcus and Staphylococcus aureus.
Of the 1557 enrolled children, 1258 were 6 to 24 months old (315 healthy and 943 AOM) and 299 were 25 to 60 months (102 healthy and 197 AOM). More then 85% were PCV7 vaccinated and the children of 25/60 months were rarely PCV13 vaccinated (14.1%) compared to younger children (69.9%, P<0.001). For children 6/24 months, the Streptococcus pneumoniae carriage was higher in AOM group (57.3%) versus healthy (28.9%). By contrast for older children, the difference (58.4% versus 50%) was not significant. In the healthy group, older children carried more often S. pneumoniae than younger children (50% versus 28.9%, P<0.0001). This trend was also observed for H. influenzae carriage (49% versus 18.7%, P<0.0001). Multivariate analysis in the healthy group showed that siblings and day care center (or school) increased the carriage of S. pneumoniae and H. influenzae.
These data from nasopharyngeal carriage in children 6 to 60 months old showed that pneumococcus and H. influenzae carriage is high for patients under 2 years, especially in the healthy group. Moreover, these data from the transition PCV7/PCV13, will serve as baseline in France to evaluate the impact of PCV13.
自2001年起，法国针对6至24个月大的儿童开展了一项鼻咽部携带情况研究。尚无关于年龄较大儿童（25至60个月）的相关数据。本研究旨在比较两个年龄组（6/24个月与25/60个月）中患有急性中耳炎（AOM）的儿童与健康儿童的鼻咽部携带情况。此外，在研究期间，13价肺炎球菌结合疫苗（PCV13）于2010年6月取代了PCV7。
2010年10月至2011年6月，58名儿科医生从6至60个月患有急性中耳炎（AOM）的儿童或健康对照中采集鼻咽拭子，以分析肺炎球菌、流感嗜血杆菌、卡他莫拉菌、A组链球菌和金黄色葡萄球菌的携带情况。
在1557名入组儿童中，1258名年龄在6至24个月（315名健康儿童和943名AOM患儿），299名年龄在25至60个月（102名健康儿童和197名AOM患儿）。超过85%的儿童接种过PCV7，与年幼儿童（69.9%）相比，25/60个月大的儿童很少接种PCV13（14.1%，P<0.001）。对于6/24个月大的儿童，AOM组的肺炎链球菌携带率（57.3%）高于健康组（28.9%）。相比之下，年龄较大儿童的差异（58.4%对50%）不显著。在健康组中，年龄较大儿童的肺炎链球菌携带率高于年幼儿童（50%对28.9%，P<0.0001）。流感嗜血杆菌携带情况也观察到了这种趋势（49%对18.7%，P<0.0001）。健康组的多因素分析表明，兄弟姐妹以及日托中心（或学校）会增加肺炎链球菌和流感嗜血杆菌的携带率。
这些6至60个月大儿童的鼻咽部携带情况数据表明，2岁以下患者的肺炎球菌和流感嗜血杆菌携带率较高，尤其是在健康组中。此外，这些PCV7/PCV13转换期的数据将作为法国评估PCV13影响的基线。
