Sterky Ellinor, Bennet Rutger, Lindstrand Ann, Eriksson Margareta, Nilsson Anna
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Public Health Agency of Sweden, Solna, Sweden.
Eur J Pediatr. 2017 Mar;176(3):337-342. doi: 10.1007/s00431-016-2843-2. Epub 2017 Jan 9.
The burden of community-acquired pneumonia (CAP) in high-income countries is still significant. The introduction of pneumococcal conjugate vaccines (PCV) has reduced the overall need for hospitalization for CAP. However, it is not clear whether children with underlying disease also have benefitted from the PCV immunization programme. Children 0 to <5 years of age hospitalized with CAP and discharged with an ICD-10 code of J13-J18.9 between November 1, 2005, and April 30, 2007 (pre-vaccination period), and November 1, 2010, and April 30, 2012 (post-vaccination period), were eligible for this study. Data on hospitalization and discharge diagnoses were retrieved from the Hospital Registry. In addition, chart review was performed in 50% of the patients. Our result confirmed a decrease in hospitalization rate for CAP in the PCV13 period. Chart review revealed that half of the patients had underlying comorbidity and these children had more severe symptoms and required longer hospital stay. Intensive care was provided to less than 10% of the children and mostly for children with an underlying neurological disease.
We show that all children have benefitted from the reduction of CAP hospitalization after introduction of PCV. Our finding emphasizes the importance of children with chronic diseases receiving adequate vaccinations that may protect from lower respiratory diseases. What is known? • Community-acquired pneumonia is a leading infectious cause of hospitalizations and death among children <5 years of age globally • Pneumococcal conjugate vaccine reduces the hospitalizations of all-cause pneumonia What is new? • We show that also children with underlying comorbidities have benefitted from PCV immunization with a reduction of CAP hospitalization • We show that approximately half of all children hospitalized with CAP also have underlying comorbidities.
在高收入国家，社区获得性肺炎（CAP）的负担仍然很重。肺炎球菌结合疫苗（PCV）的引入降低了CAP住院治疗的总体需求。然而，尚不清楚患有基础疾病的儿童是否也从PCV免疫计划中受益。2005年11月1日至2007年4月30日（疫苗接种前时期）以及2010年11月1日至2012年4月30日（疫苗接种后时期），因CAP住院且出院时ICD - 10编码为J13 - J18.9的0至<5岁儿童符合本研究条件。住院和出院诊断数据从医院登记处获取。此外，对50%的患者进行了病历审查。我们的结果证实了PCV13时期CAP住院率的下降。病历审查显示，一半的患者有基础合并症，这些儿童症状更严重，住院时间更长。不到10%的儿童接受了重症监护，主要是患有基础神经疾病的儿童。
我们表明，引入PCV后，所有儿童都从CAP住院率的降低中受益。我们的发现强调了慢性病儿童接种足够疫苗以预防下呼吸道疾病的重要性。已知信息有哪些？• 社区获得性肺炎是全球5岁以下儿童住院和死亡的主要感染原因 • 肺炎球菌结合疫苗可降低全因性肺炎的住院率 新发现有哪些？• 我们表明，患有基础合并症的儿童也从PCV免疫中受益，CAP住院率降低 • 我们表明，所有因CAP住院的儿童中约有一半也有基础合并症。
