Su Lin-Hui, Kuo An-Jing, Chia Ju-Hsin, Li Hsin-Chieh, Wu Tsu-Lan, Feng Ye, Chiu Cheng-Hsun
Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.
Chang Gung University College of Medicine, Taoyuan, 333, Taiwan.
Sci Rep. 2015 Nov 2;5:15843. doi: 10.1038/srep15843.
In Taiwan, beginning in 2013, the 13-valent pneumococcal conjugate vaccine (PCV13) was provided free of charge to children 2-5 years of age. In 2014, this was extended to children 1-5 years old. During 2012-2014, 953 cases of culture-confirmed pneumococcal disease (CCPD), including 104 invasive pneumococcal disease (IPD), were prospectively identified and analyzed at a 3,700-bed hospital in Taiwan. From 2012 to 2014, the incidence per 10,000 admissions decreased from 26.7 to 20.4 for CCPD (P < 0.001) and from 3.2 to 1.9 for IPD (P < 0.05). Significant reduction of PCV13 serotypes was firstly noted in children in 2013 and extended to both paediatric and adult populations in 2014. Simultaneously, the incidence per 10,000 admissions of non-PCV13 serotypes increased from 6.1 in 2012 to 9.3 in 2014 (P < 0.005). The most prevalent non-PCV13 serotypes were 15A, 15B, and 23A, each containing a predominant clone, ST63(15A), ST83(15B), and ST338(23A). From 2012 to 2014, isolates with penicillin minimum inhibitory concentrations >2 mg/L decreased from 27.8% to 8.1% (P < 0.001) among all isolates. PCV13 immunization in young children demonstrated an early protective effect in all ages. However, in the elderly, the effect was compromised by an emergence of non-PCV13 serotypes.
在台湾，自2013年起，13价肺炎球菌结合疫苗（PCV13）开始免费提供给2至5岁的儿童。2014年，这一范围扩大至1至5岁的儿童。2012年至2014年期间，在台湾一家拥有3700张床位的医院对953例经培养确诊的肺炎球菌疾病（CCPD）病例进行了前瞻性鉴定和分析，其中包括104例侵袭性肺炎球菌疾病（IPD）。2012年至2014年，CCPD每10000例住院患者中的发病率从26.7降至20.4（P＜0.001），IPD从3.2降至1.9（P＜0.05）。2013年首次注意到PCV13血清型在儿童中显著减少，并于2014年扩展至儿童和成人人群。同时，非PCV13血清型每10000例住院患者中的发病率从2012年的6.1增至2014年的9.3（P＜0.005）。最常见的非PCV13血清型为15A、15B和23A，每种血清型都包含一个主要克隆，即ST63（15A）、ST83（15B）和ST338（23A）。2012年至2014年，在所有分离株中，青霉素最低抑菌浓度＞2mg/L的分离株从27.8%降至8.1%（P＜0.001）。幼儿接种PCV13疫苗在各年龄段均显示出早期保护作用。然而，在老年人中，这种效果因非PCV13血清型的出现而受到影响。
