1986-2009 年期间，来自阿拉斯加的侵袭性和带菌分离株中肺炎链球菌 6A 型和 6C 型的流行病学研究。
Epidemiology of pneumococcal serotype 6A and 6C among invasive and carriage isolates from Alaska, 1986-2009.
机构信息
Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, AK 99508, USA.
出版信息
Diagn Microbiol Infect Dis. 2013 Mar;75(3):271-6. doi: 10.1016/j.diagmicrobio.2012.11.021. Epub 2012 Dec 28.
We investigated serotype 6A/6C invasive pneumococcal disease (IPD) incidence, genetic diversity, and carriage before and after 7-valent pneumococcal conjugate vaccine (PCV7) introduction in Alaska. IPD cases (1986-2009) were identified through population-based laboratory surveillance. Isolates were initially serotyped by conventional methods, and 6C isolates were differentiated from 6A by polymerase chain reaction. Among invasive and carriage isolates initially typed as 6A, 35% and 50% were identified as 6C, respectively. IPD rates caused by serotype 6A or 6C among children <5 years did not change from the pre- to post-PCV7 period (P = 0.71 and P = 0.09, respectively). Multilocus sequence typing of IPD isolates revealed 28 sequence types. The proportion of serotype 6A carriage isolates decreased from 7.4% pre-PCV7 to 1.8% (P < 0.001) during 2008-2009; the proportion of serotype 6C carriage isolates increased from 3.0% to 8.4% (P = 0.004) among children <5 years. Continued surveillance is warranted to monitor changes in serotype distribution and prevalence.
我们研究了 7 价肺炎球菌结合疫苗（PCV7）引入前后，阿拉斯加 6A/6C 型侵袭性肺炎球菌病（IPD）的发病率、遗传多样性和携带情况。通过基于人群的实验室监测确定了 IPD 病例（1986-2009 年）。分离株最初通过常规方法进行血清型分型，6C 分离株通过聚合酶链反应与 6A 分离株区分。在最初被鉴定为 6A 的侵袭性和携带分离株中，分别有 35%和 50%被鉴定为 6C。5 岁以下儿童的 6A 或 6C 血清型引起的 IPD 发病率在 PCV7 引入前后没有变化（P=0.71 和 P=0.09）。对 IPD 分离株的多位点序列分型显示有 28 种序列型。6A 携带分离株的比例从 PCV7 引入前的 7.4%降至 2008-2009 年的 1.8%（P<0.001）；5 岁以下儿童 6C 携带分离株的比例从 3.0%增加到 8.4%（P=0.004）。需要继续监测以监测血清型分布和流行率的变化。
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