Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
Vaccine. 2013 Oct 1;31(42):4820-6. doi: 10.1016/j.vaccine.2013.07.079. Epub 2013 Aug 17.
The Advisory Committee on Immunization Practices (ACIP) recommended the inclusion of asthma as a high-risk condition that should warrant pneumococcal vaccination, but the National Advisory Committee on Immunization (NACI) in Canada has not yet done so. We aimed to determine the risk of invasive pneumococcal disease (IPD) in patients with asthma.
We searched Ovid Medline, EMBASE, Classic EMBASE, PubMEd and Cochrane for articles published between January 1990 and February 2013, using the MeSH terms pneumococcal infections/or invasive pneumococcal disease and asthma. Google Scholar was used to retrieve articles citing the seminal article by Talbot et al. Articles were included if they were population-based studies that evaluated the relationship between IPD and asthma. Two authors independently assessed all titles and abstracts. All potentially relevant articles were retrieved as full text and assessed for inclusion.
The combined searches yielded 376 articles, which were reviewed by title and abstract. At this stage, 330 articles were excluded; 40 articles were excluded at the full article review stage - leaving 6 articles. Two additional articles were found through Google Scholar. The evidence reviewed consistently showed a positive association between asthma and risk of IPD. However, the magnitude of this effect was heterogeneous with adjusted odds ratios ranging from 6.7 (95% CI 1.6-27.3) in adults >18 years to 1.7 (95% CI 0.99-3.0) in individuals aged 2-49 with low-risk asthma.
The positive association between asthma and risk of IPD supports the addition of asthma as a high-risk condition warranting pneumococcal vaccination. Data on vaccine effectiveness in this population is needed.
免疫实践咨询委员会（ACIP）建议将哮喘作为一种高危疾病纳入肺炎球菌疫苗接种范围，但加拿大国家免疫咨询委员会（NACI）尚未这样做。我们旨在确定哮喘患者患侵袭性肺炎球菌病（IPD）的风险。
我们在 Ovid Medline、EMBASE、经典 EMBASE、PubMEd 和 Cochrane 中使用肺炎球菌感染/侵袭性肺炎球菌病和哮喘的 MeSH 术语进行了 1990 年 1 月至 2013 年 2 月期间发表的文章检索，使用 Google Scholar 检索引用 Talbot 等人的开创性文章的文章。如果文章是评估 IPD 与哮喘之间关系的基于人群的研究，则将其纳入。两位作者独立评估了所有标题和摘要。检索了所有可能相关的文章作为全文，并评估了纳入情况。
联合检索共产生 376 篇文章，对其进行了标题和摘要的审查。在这一阶段，有 330 篇文章被排除在外；40 篇文章在全文审查阶段被排除在外——留下 6 篇文章。通过 Google Scholar 还找到了另外 2 篇文章。审查的证据一致表明哮喘与 IPD 风险之间存在正相关关系。然而，这种效应的幅度存在异质性，调整后的优势比范围从成年人（年龄>18 岁）的 6.7（95%CI 1.6-27.3）到患有低危哮喘的 2-49 岁个体的 1.7（95%CI 0.99-3.0）。
哮喘与 IPD 风险之间的正相关关系支持将哮喘作为一种高危疾病纳入肺炎球菌疫苗接种范围。需要了解该人群中疫苗有效性的数据。
