Hospital de Niños "Ricardo Gutiérrez," Buenos Aires, Argentina.
Hospital de Niños "Santísima Trinidad," Córdoba, Argentina.
J Pediatric Infect Dis Soc. 2018 Feb 19;7(1):30-35. doi: 10.1093/jpids/piw089.
In January 2012, Argentina included universal pneumococcal vaccination in the routine childhood vaccination program using a 13-valent pneumococcal conjugate vaccine (PCV13). A 2 + 1 schedule (2 doses in the first year of life and a booster dose at 12 months of age) in children aged <2 years and 2-dose catch-up immunization in children aged 13 to 24 months was administered during the first year of vaccine introduction. The purpose of this study was to assess the burdens of invasive pneumococcal disease (IPD) and/or community-acquired pneumonia (CAP) in hospitalized children younger than 5 years during the first 2 years of the program compared to those in the prevaccination period in our setting.
This was a multicenter, prospective, and descriptive study. Rates of hospitalization resulting from IPD and/or CAP in 5 pediatric reference centers across the country were analyzed (every 10 000 admissions). Clinical, epidemiologic, and microbiological data were recorded. Statistical analysis using Stata 8.0 was performed.
A comparison of rates of hospitalization resulting from global IPD and/or CAP in the prevaccine (2009-2011) and postvaccine (2012-2013) periods revealed significant decreases of 50% (P = .003) and 51% (P < .0001), respectively. Significant decreases were also observed in number of hospitalizations resulting from empyema (39%; P = .03) and pneumococcal empyema (67.8%; P = .007); the reduction was not statistically significant for pneumococcal CAP (58%; P = .18). Hospital stays for IPD and/or CAP decreased by 56%.
Rapid and significant decreases in the rates of hospitalization resulting from IPD and/or CAP during the first 2 years after PCV13 introduction were observed. A longer surveillance period is required to confirm these results and the effectiveness of the vaccination program.
2012 年 1 月，阿根廷将 13 价肺炎球菌结合疫苗（PCV13）纳入常规儿童免疫规划，实行通用肺炎球菌疫苗接种。在疫苗接种第一年，为年龄<2 岁的儿童接种 2+1 方案（即出生后第 1 年接种 2 剂，12 月龄时加强接种 1 剂），为 13 至 24 月龄的儿童补种 2 剂。本研究旨在评估在我们的环境中，与疫苗接种前相比，在该计划实施的头 2 年中，5 岁以下住院儿童侵袭性肺炎球菌病（IPD）和/或社区获得性肺炎（CAP）的负担。
这是一项多中心、前瞻性和描述性研究。对全国 5 个儿科参考中心因 IPD 和/或 CAP 住院的发生率（每 10000 例住院患者）进行分析。记录临床、流行病学和微生物学数据。使用 Stata 8.0 进行统计分析。
与疫苗接种前（2009-2011 年）和疫苗接种后（2012-2013 年）相比，全球 IPD 和/或 CAP 导致的住院率比较显示，分别显著下降 50%（P=0.003）和 51%（P<0.0001）。脓胸（39%；P=0.03）和肺炎球菌性脓胸（67.8%；P=0.007）导致的住院人数也显著减少；肺炎球菌性 CAP 下降无统计学意义（58%；P=0.18）。IPD 和/或 CAP 的住院时间减少了 56%。
在 PCV13 引入后的头 2 年中，IPD 和/或 CAP 的住院率迅速显著下降。需要更长的监测期来确认这些结果和疫苗接种计划的有效性。
