婴儿免疫接种与农村南非社区鼻咽定植的肺炎链球菌、流感嗜血杆菌和金黄色葡萄球菌生态学的时间关联。
Temporal association of infant immunisation with pneumococcal conjugate vaccine on the ecology of Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus nasopharyngeal colonisation in a rural South African community.
机构信息
Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Department of Global Health, Rollins School of Public Health, Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA, USA.
出版信息
Vaccine. 2014 Sep 22;32(42):5520-30. doi: 10.1016/j.vaccine.2014.06.091. Epub 2014 Aug 4.
BACKGROUND
Immunisation of children with pneumococcal conjugate vaccines (PCV) may affect the bacterial-ecology of the nasopharynx, including colonisation by Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus. The aim of this study was to evaluate the effect of infant PCV-immunisation on the nasopharyngeal ecology of these potentially pathogenic bacteria in a rural African setting.
METHODS
Two cross sectional surveys were undertaken from May to October in 2009 (Period-1) which coincided with the introduction of 7-valent PCV (PCV7) and in May-October 2011 (Period-2). Consenting household members, where there was a child <2 years of age in residence, had nasopharyngeal swabs undertaken for culture.
RESULTS
From Period-1 to Period-2 in children 0-2 years and 3-12 years, prevalence of overall S. pneumoniae colonisation decreased from 74.9% to 67.0% (p<0.001) and H. influenzae declined among children 3-12 years (55.1-45.3%, p<0.001) but not among those <2 years. The prevalence of S. aureus remained unchanged in all children. Competitive associations were found between S. pneumoniae and S. aureus and between H. influenzae and S. aureus among children. In individuals >12 years, the prevalence of colonisation decreased from 11.2% to 6.8%, 16.7% to 8.8% and 31.2% to 23.7% for S. pneumoniae, H. influenzae and S. aureus, respectively; p<0.001 for all comparions. Synergistic relationships for S. aureus with H. influenzae and S. pneumoniae were observed in both periods among this group.
背景
儿童接种肺炎球菌结合疫苗（PCV）可能会影响鼻咽部的细菌生态，包括肺炎链球菌、流感嗜血杆菌和金黄色葡萄球菌的定植。本研究旨在评估在农村非洲环境中，婴儿 PCV 免疫接种对这些潜在致病细菌鼻咽部生态的影响。
方法
2009 年 5 月至 10 月（第 1 期）和 2011 年 5 月至 10 月（第 2 期）进行了两次横断面调查，恰逢 7 价 PCV（PCV7）的引入。同意参与的家庭成员中，如果有 2 岁以下的儿童居住，进行鼻咽拭子培养。
结果
在 0-2 岁和 3-12 岁的儿童中，从第 1 期到第 2 期，总体肺炎链球菌定植的患病率从 74.9%降至 67.0%（p<0.001），3-12 岁儿童的流感嗜血杆菌下降（55.1-45.3%，p<0.001），但 2 岁以下儿童没有下降。所有儿童的金黄色葡萄球菌患病率保持不变。在儿童中发现了肺炎链球菌和金黄色葡萄球菌之间以及流感嗜血杆菌和金黄色葡萄球菌之间的竞争关联。在>12 岁的个体中，肺炎链球菌、流感嗜血杆菌和金黄色葡萄球菌的定植率分别从 11.2%降至 6.8%、16.7%降至 8.8%和 31.2%降至 23.7%；所有比较均 p<0.001。在这组人群中，两个时期均观察到金黄色葡萄球菌与流感嗜血杆菌和肺炎链球菌之间的协同关系。
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