Department of Respiratory Medicine, Sydney Children's Hospital, High Street, Randwick, Sydney NSW 2031, Australia.
Bull World Health Organ. 2013 Mar 1;91(3):167-73. doi: 10.2471/BLT.12.109231. Epub 2012 Dec 11.
To examine rates of paediatric hospitalization for empyema and pneumonia in Australia before and after the introduction of the seven-valent pneumococcal conjugate vaccine (PCV7).
Rates of paediatric hospitalization for empyema and pneumonia (bacterial, viral and all types) were calculated following the codes of the International Classification of Diseases, tenth revision (ICD-10) as a principal diagnosis. The expected number of hospitalizations after the PCV7 was introduced was estimated on the basis of the observed number of hospitalizations before the introduction of the PCV7. Incidence rate differences (IRDs) and incidence rate ratios (IRRs) were calculated. Hospitalization incidence in each study period was expressed as the number of hospitalizations per million (10(6)) person-years. The population of children aged 0-19 years in Australia from 1998 to 2004 and from 2005 to 2010, as reported by the Australian Bureau of Statistics, was used to calculate the number of person-years in each period.
In the 5 years following the introduction of the PCV7, hospitalizations for pneumonia were fewer than expected (15 304 fewer; 95% confidence interval, CI: 14 646-15 960; IRD: -552 per 10(6) person-years; 95% CI: -576 to -529 per 10(6) person-years; IRR: 0.78; 95% CI: 0.77-0.78). Hospitalizations for empyema, on the other hand, were more than expected (83 more; 95% CI: 37-128; IRD: 3 per 10(6) person-years; 95% CI: 1-5 per 10(6) person-years; IRR: 1.35; 95% CI: 1.14-1.59). Reductions in hospitalizations were observed for all ICD-10 pneumonia codes across all age groups. The increase in empyema hospitalizations was only significant among children aged 1 to 4 years.
The introduction of the PCV7 in Australia was associated with a substantial decrease in hospitalizations for childhood pneumonia and a small increase in hospitalizations for empyema.
研究澳大利亚在引入 7 价肺炎球菌结合疫苗（PCV7）前后儿童脓胸和肺炎住院率的变化。
根据国际疾病分类第十版（ICD-10）的编码，将脓胸和肺炎（细菌性、病毒性和所有类型）的儿童住院率作为主要诊断进行计算。根据 PCV7 引入前的实际住院人数，估计 PCV7 引入后的预期住院人数。计算发病率差异（IRD）和发病率比（IRR）。每个研究期间的住院发生率以每百万人（10^6）人年的住院人数表示。澳大利亚统计局报告的 1998 年至 2004 年和 2005 年至 2010 年期间 0-19 岁儿童的人口用于计算每个时期的人数。
在 PCV7 引入后的 5 年内，肺炎住院人数低于预期（少 15304 人；95%置信区间，CI：14646-15960；IRD：-552/10^6 人年；95% CI：-576 至-529/10^6 人年；IRR：0.78；95% CI：0.77-0.78）。另一方面，脓胸住院人数高于预期（多 83 人；95% CI：37-128；IRD：3/10^6 人年；95% CI：1-5/10^6 人年；IRR：1.35；95% CI：1.14-1.59）。所有年龄组的所有 ICD-10 肺炎编码的住院人数均有所减少。脓胸住院人数的增加仅在 1 至 4 岁儿童中具有统计学意义。
澳大利亚引入 PCV7 后，儿童肺炎住院率显著下降，脓胸住院率略有增加。
