Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan.
J Microbiol Immunol Infect. 2018 Jun;51(3):332-336. doi: 10.1016/j.jmii.2016.08.009. Epub 2016 Dec 18.
Invasive pneumococcal disease (IPD) causes significant morbidity and mortality, especially in children and older adults. Pneumococcal 7-valent and 13-valent conjugate vaccines (PCV7 and PCV13) were introduced in Taiwan in 2005 and 2011, respectively, for children. This study was conducted to evaluate the impact of PCV administered in children on adult IPD.
From the logbooks of microbiology laboratories, we retrospectively retrieved Streptococcus pneumoniae isolates, collected from normally sterile sites in adult patients. One hundred and fifty-seven consecutive, nonduplicated isolates were collected from one hospital during 2001 and 2003 (pre-PCV period) and 150 isolates from three hospitals from July 2011 to June 2015 (post-PCV period). Serotypes were determined by Quellung test.
Among the 307 isolates, 31 serotypes/serogroups were identified. PCV7 serotypes, particularly types 14 (31.2%), 23F (19.7%) and 6B (12.7%) dominated in the pre-PCV period (78.3%) but significantly decreased in the post-PCV period (36%) (p < 0.01). PCV13 specific serotypes (PCV13-PCV7) significantly increased from 7% of the isolates in the pre-PCV period to 28.7% of the isolates in the post-PCV period (p < 0.001), particularly type 19A (from 0.6% to 10%) and 6A (from 0 to 6.7%). Serotype 15B also increased significantly from 0.6% to 6.7% (p < 0.01). Nonvaccine serotypes increased significantly in the post-PCV period (11.5% to 22.0%, p < 0.05), particularly type 15A (from 0 to 4.4%, p < 0.01).
Serotype distribution of adult IPD in Taiwan has evolved after the introduction of PCV in children, indicating an indirect impact in adults. Continuous surveillance after the PCV13 vaccination program in children is needed.
侵袭性肺炎球菌病（IPD）会导致严重的发病率和死亡率，尤其是在儿童和老年人中。肺炎球菌 7 价和 13 价结合疫苗（PCV7 和 PCV13）分别于 2005 年和 2011 年在台湾被引入用于儿童接种。本研究旨在评估儿童接种 PCV 对成人 IPD 的影响。
我们从微生物学实验室的日志中回顾性地检索了来自成人患者无菌部位的肺炎链球菌分离株。2001 年至 2003 年（PCV 前时期），一家医院连续收集了 157 例非重复分离株，2011 年 7 月至 2015 年 6 月，三家医院共收集了 150 例分离株。血清型通过 Quellung 试验确定。
在 307 株分离株中，鉴定出 31 种血清型/血清群。PCV7 血清型，特别是 14 型（31.2%）、23F（19.7%）和 6B（12.7%）在 PCV 前时期（78.3%）占主导地位，但在 PCV 后时期（36%）显著下降（p<0.01）。PCV13 特定血清型（PCV13-PCV7）从 PCV 前时期的 7%的分离株显著增加到 PCV 后时期的 28.7%的分离株（p<0.001），特别是 19A 型（从 0.6%到 10%）和 6A 型（从 0 到 6.7%）。血清型 15B 也从 0.6%显著增加到 6.7%（p<0.01）。PCV 后时期非疫苗血清型显著增加（11.5%至 22.0%，p<0.05），特别是 15A 型（从 0 到 4.4%，p<0.01）。
台湾成人 IPD 的血清型分布在儿童接种 PCV 后发生了演变，表明对成年人有间接影响。在儿童接种 PCV13 疫苗计划后需要进行持续监测。
