Ochoa-Gondar Olga, Gómez-Bertomeu Frederic, Vila-Córcoles Angel, Raga Xavier, Aguirre Carlos, Utrera Jesús, de Diego Cinta, Guzmán Jorge A, Figuerola Enric
Olga Ochoa Gondar, Servicio de Atención Primaria Camp de Tarragona. ICS, Rambla Nova 124, D, 1ºA. 43001. Tarragona, Spain.
Rev Esp Quimioter. 2015 Feb;28(1):29-35.
Pneumococcal infections remain a major health problem worldwide. This study analysed the distribution of distinct Streptococcus pneumoniae serotypes causing invasive pneumococcal disease (IPD) among all-age population in the region of Tarragona (Spain) throughout 2006-2009.
An amount of 237 strains were evaluated, of which 203 (85.7%) were isolated from blood cultures, 14 (5.9%) from pleural fluids, 13 (5.5%) from CSF samples and 7 (3%) from other sterile sites. Forty-seven cases (19.8%) were children ≤ 14 years, 94 (39.7%) were patients 15-64 years and 96 (40.5%) were patients ≥ 65 years.
Seven serotypes (1, 3, 6A, 7F, 12F, 14 and 19A) caused almost two thirds (63.3%) of cases among all-age patients. Serotype 1 was the most common serotype among children (44.7%) and among people 15-64 years (21.3%), whereas serotype 19A was the most common among people ≥ 65 years (12.5%).Among all-age population, serotype-vaccine coverage for the distinct pneumococcal polysaccharide vaccine (PPV) and conjugate vaccines (PCVs) were 17.3% for the PCV7, 49.8% for the PCV10, 73% for the PCV13 and 80.2% for the PPV23 (p < 0.001). Among children, vaccine-serotype coverage was 23.4% for the PCV7, 72.3% for the PCV10 and 83% for the PCV13. Among people ≥ 65 years, vaccine-serotype coverage was 62.5% for the PCV13 and 68.8% for the PPV23.
A considerable proportion of IPD cases among our population would not be covered by the current pneumococcal vaccines.
肺炎球菌感染仍是全球主要的健康问题。本研究分析了2006 - 2009年期间西班牙塔拉戈纳地区全年龄段人群中引起侵袭性肺炎球菌病(IPD)的不同肺炎链球菌血清型的分布情况。
共评估了237株菌株,其中203株(85.7%)从血培养中分离得到,14株(5.9%)从胸腔积液中分离得到,13株(5.5%)从脑脊液样本中分离得到,7株(3%)从其他无菌部位分离得到。47例(19.8%)为14岁及以下儿童,94例(39.7%)为15 - 64岁患者,96例(40.5%)为65岁及以上患者。
七种血清型(1、3、6A、7F、12F、14和19A)导致了全年龄段患者中近三分之二(63.3%)的病例。血清型1是儿童(44.7%)和15 - 64岁人群(21.3%)中最常见的血清型,而血清型19A是65岁及以上人群中最常见的血清型(12.5%)。在全年龄段人群中,不同肺炎球菌多糖疫苗(PPV)和结合疫苗(PCV)的血清型疫苗覆盖率分别为:PCV7为17.3%,PCV10为49.8%,PCV13为73%,PPV23为80.2%(p < 0.001)。在儿童中,PCV7的疫苗血清型覆盖率为23.4%,PCV10为72.3%,PCV13为83%。在65岁及以上人群中,PCV13的疫苗血清型覆盖率为62.5%,PPV23为68.8%。
我们人群中相当一部分IPD病例无法被目前的肺炎球菌疫苗所覆盖。