Pediatric Infectious Diseases Sections of the Baylor College of Medicine, Houston, TX 77030, USA.
Pediatr Infect Dis J. 2013 Mar;32(3):203-7. doi: 10.1097/INF.0b013e318275614b.
The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced for routine administration to infants and children in 2010 in the United States. We have monitored clinical and microbiologic features of invasive pneumococcal infections among children before and after PCV13 use.
Infants and children cared for at 8 children hospitals in the United States with culture-proven invasive infections caused by S. pneumoniae were identified in an ongoing prospective surveillance study. Demographic and clinical data were recorded on a standard case report form. Serotype and antimicrobial susceptibilities of isolates were determined.
Since routine PCV13 immunization in 2010, invasive pneumococcal infections decreased 42% overall and 53% for children <24 months of age in 2011 compared with the average number of cases for 2007 to 2009. PCV13 serotype isolates decreased 57% during these same time periods; 19A, 7F and 3 decreased by 58%, 54% and 68%, respectively. The number of infections caused by serotypes 1 and 6C also decreased in 2011. The most common non-PCV13 serotypes encountered in 2010 and 2011 combined were 33F, 22F, 12, 15B, 15C, 23A and 11. Bacteremia, pneumonia and mastoiditis cases decreased more than meningitis cases.
After the introduction of PCV13, invasive pneumococcal infections decreased among 8 children hospitals compared with the 3 years before PCV13 use. Slight increases in some non-PCV13 serotype isolates were noted in 2011. Continued surveillance is necessary to determine the effectiveness of PCV13 including herd protection as well as any emerging invasive serotypes.
2010 年，美国开始将 13 价肺炎球菌结合疫苗（PCV13）常规用于婴幼儿接种。在此之前和之后，我们一直在监测儿童侵袭性肺炎球菌感染的临床和微生物学特征。
在美国 8 家儿童医院进行的一项正在进行的前瞻性监测研究中，确定了由肺炎链球菌引起的经培养证实的侵袭性感染的婴儿和儿童。记录了人口统计学和临床数据的标准病例报告表。确定了分离株的血清型和抗菌药物敏感性。
自 2010 年常规接种 PCV13 以来，2011 年侵袭性肺炎球菌感染总体减少了 42%，24 个月以下儿童减少了 53%，与 2007 年至 2009 年的平均病例数相比。同期 PCV13 血清型分离株减少了 57%；19A、7F 和 3 分别减少了 58%、54%和 68%。2011 年，1 型和 6C 型感染的数量也有所减少。2010 年和 2011 年联合发现的最常见的非 PCV13 血清型是 33F、22F、12、15B、15C、23A 和 11。菌血症、肺炎和乳突炎病例的减少超过了脑膜炎病例。
PCV13 推出后，与使用 PCV13 前的 3 年相比，8 家儿童医院侵袭性肺炎球菌感染有所减少。2011 年注意到一些非 PCV13 血清型分离株略有增加。需要继续监测以确定 PCV13 的有效性，包括群体保护以及任何新出现的侵袭性血清型。
