2002-2010 年比利时婴幼儿肺炎球菌疫苗接种前后侵袭性肺炎球菌病血清型流行趋势。

Trends in serotype prevalence in invasive pneumococcal disease before and after infant pneumococcal vaccination in Belgium, 2002-2010.

机构信息

Department of Internal Medicine, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.

出版信息

Vaccine. 2013 Mar 1;31(11):1529-34. doi: 10.1016/j.vaccine.2012.11.103. Epub 2012 Dec 20.

DOI:10.1016/j.vaccine.2012.11.103

PMID:23261044

Abstract

OBJECTIVES

We evaluated the effect of the infant 7-valent pneumococcal conjugate vaccine (PCV7) program on the serotype distribution in invasive pneumococcal disease in the Belgian population.

METHODS

Serotyping was performed on 13,998 bacteraemic and pleural fluid isolates sent to the National Reference Laboratory between 2002 and 2010. We compared the distribution of serogroups (SGs) between the pre- (2002-2004) and post-PCV7 (2007-2010) era for children (<18 years), adults (18-59 years) and older individuals (≥60 years).

RESULTS

The proportion of cases caused by PCV7-SGs in subjects <18 years decreased from 69% pre-PCV7 to 26% post-PCV7 (p<0.005) and the majority of cases caused by PCV7-SGs were caused by SG 19. Post-PCV7, the prevalence of PCV7-SGs decreased from 38% to 29% and from 57% to 35% in subjects in the age groups 18-59 and ≥60 years, respectively (p<0.005). Post-PCV7 the prevalence of SGs 1, 7 and 19 increased significantly in subjects aged <18 years. The increase of SG19 was caused by an increase of serotype 19A in this age group (p<0.005). After the introduction of infant PCV7 the largest rise in prevalence occurred for SGs 7, 12 and 22 (p<0.005) in the two older age categories. Post PCV7, the overall PCV13 and 23-valent pneumococcal polysaccharide vaccine coverage rates decreased from 85% to 69% and from 96% to 93%, respectively (p<0.005).

CONCLUSIONS

PCV7 has an impact on SG distribution of invasive pneumococcal disease isolates of vaccinated and unvaccinated subjects. SG replacement forms a major threat to the success of PCV7. PCV13, including several additional replacement serotypes (STs 1, 7F, 19A), represents an attractive alternative.

摘要

目的

我们评估了婴儿 7 价肺炎球菌结合疫苗（PCV7）计划对比利时人群侵袭性肺炎球菌病血清型分布的影响。

方法

2002 年至 2010 年间，对国家参考实验室收到的 13998 例菌血症和胸腔液分离株进行血清分型。我们比较了 PCV7 前（2002-2004 年）和 PCV7 后（2007-2010 年）时代儿童（<18 岁）、成人（18-59 岁）和老年人（≥60 岁）之间血清群（SG）的分布。

结果

<18 岁人群中由 PCV7-SG 引起的病例比例从 PCV7 前的 69%降至 PCV7 后的 26%（p<0.005），且大多数由 PCV7-SG 引起的病例由 SG19 引起。PCV7 后，18-59 岁和≥60 岁人群中 PCV7-SG 的流行率分别从 38%降至 29%和从 57%降至 35%（p<0.005）。PCV7 后，<18 岁人群中 SG1、7 和 19 的流行率显著增加。该年龄组 19A 血清型的增加导致 SG19 的增加（p<0.005）。婴儿 PCV7 接种后，两个年龄组中 SG7、12 和 22 的流行率增加最大（p<0.005）。PCV7 后，总体 PCV13 和 23 价肺炎球菌多糖疫苗覆盖率分别从 85%降至 69%和从 96%降至 93%（p<0.005）。