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结合疫苗时代加泰罗尼亚地区可通过疫苗预防的侵袭性疾病流行病学

Epidemiology of vaccine-preventable invasive diseases in Catalonia in the era of conjugate vaccines.

作者信息

Ciruela Pilar, Martínez Ana, Izquierdo Conchita, Hernández Sergi, Broner Sonia, Muñoz-Almagro Carmen, Domínguez Àngela

机构信息

Public Health Agency of Catalonia; Barcelona, Spain.

出版信息

Hum Vaccin Immunother. 2013 Mar;9(3):681-91. doi: 10.4161/hv.23266. Epub 2013 Jan 9.

Abstract

We investigated the incidence and distribution of cases of invasive pneumococcal disease (IPD), invasive meningococcal disease (IMD) and invasive Hemophilus influenzae disease (IHiD) notified by hospital laboratories to the Microbiological Reporting System of Catalonia between 2005 and 2009. Incidence rates were compared using the rate ratio (RR) and 95% CI were calculated. A value of p < 0.05 was considered statistically significant. Of the 6,661 cases, 6,012 were IPD, 436 IMD and 213 IHiD. The global annual incidence per 10 ( 5) inhabitants was 16.62 (95% CI 16.20-17.04) for IPD, 1.21 (95% CI 1.09-1.32) for IMD and 0.59 (95% CI 0.51-0.67) for IHiD. IPD increased in 2009 compared with 2005 (RR:1.55, 95%CI: 1.43-1.70) and IMD and IHiD remained stable. Pneumonia was the most-frequent clinical manifestation of IPD (75.6%) and IHiD (44.1%) and meningoencephalitis with or without sepsis for IMD (70.6%). The male:female ratio was 1.37 for IPD, 1.0 for IMD and 1.15 for IHiD. The age groups with the highest incidence were the ≤ 2 y and 2-4 y groups for IPD (66.40 and 50.66/100,000 persons-year) and IMD (14.88 and 7.26/100,000 persons-year) and the ≤ 2 y and ≥ 65 y groups for IHiD (1.88 and 1.89/100,000 persons-year). The most-frequent serotypes were serotype 1 (19.0%) in IPD and untypeable serotypes (60.8%) in IHiD. Serogroup B (78.3%) was the most frequent in IMD. S. pneumoniae is the most-frequent agent causing invasive disease in Catalonia. The main clinical manifestations were pneumonia in IPD and IHiD and meningitis in IMD. The main causative agent of meningitis was N. meningitidis in people aged < 20 y and S. pneumoniae in people aged ≥ 20 y. Vaccination with conjugate vaccines may reduce the risk of infectious disease in our setting.

摘要

我们调查了2005年至2009年间医院实验室向加泰罗尼亚微生物报告系统通报的侵袭性肺炎球菌疾病(IPD)、侵袭性脑膜炎球菌疾病(IMD)和侵袭性流感嗜血杆菌疾病(IHiD)病例的发病率及分布情况。使用率比(RR)比较发病率,并计算95%置信区间(CI)。p值<0.05被认为具有统计学意义。在6661例病例中,IPD有6012例,IMD有436例,IHiD有213例。IPD每10(5)名居民的全球年发病率为16.62(95%CI 16.20 - 17.04),IMD为1.21(95%CI 1.09 - 1.32),IHiD为0.59(95%CI 0.51 - 0.67)。与2005年相比,2009年IPD发病率上升(RR:1.55,95%CI:1.43 - 1.70),IMD和IHiD保持稳定。肺炎是IPD(75.6%)和IHiD(44.1%)最常见的临床表现,IMD则是伴有或不伴有败血症的脑膜脑炎(70.6%)。IPD的男女比例为1.37,IMD为1.0,IHiD为1.15。IPD发病率最高的年龄组是≤2岁组和2 - 4岁组(分别为66.40和50.66/10万人口年)以及IMD(分别为14.88和7.26/10万人口年),IHiD发病率最高的年龄组是≤2岁组和≥65岁组(分别为1.88和1.89/10万人口年)。IPD中最常见的血清型是1型(19.0%),IHiD中是不可分型血清型(60.8%)。B群(78.3%)是IMD中最常见的血清群。肺炎链球菌是加泰罗尼亚引起侵袭性疾病最常见的病原体。主要临床表现为IPD和IHiD中的肺炎以及IMD中的脑膜炎。<20岁人群中脑膜炎的主要病原体是脑膜炎奈瑟菌,≥20岁人群中是肺炎链球菌。接种结合疫苗可能会降低我们地区传染病的风险。

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本文引用的文献

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Pneumococcal disease surveillance in Europe.欧洲的肺炎球菌疾病监测
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