McCarthy Hannah, Jackson Mandy, Corcoran Mary, McElligott Martha, MacHale Elaine, Sulaiman Imran, Cushen Breda, Costello Richard W, Humpreys Hilary
Department of Clinical Microbiology, Royal College of Surgeons in Ireland, RCSI Education and Research Centre, Beaumont Hospital, Beaumont, Dublin, Republic of Ireland.
Irish Pneumococcal Reference Laboratory, Epidemiology and Molecular Biology Unit Laboratory, Temple Street Children's University Hospital, Dublin, Republic of Ireland.
BMJ Open. 2017 Jul 9;7(7):e013944. doi: 10.1136/bmjopen-2016-013944.
To characterise the pattern of colonisation and serotypes of among patients with chronic obstructive pulmonary disease (COPD) who currently receive the 23-valent pneumococcal polysaccharide vaccine (PPV-23) according to vaccination status, use of antibiotics and steroids. To investigate the prevalence of PPV-23 and 13-valent pneumococcal conjugate vaccine (PCV-13) serotypes within the study cohort.
A non-interventional, observational, prospective cohort study with a 12 -month follow-up period inclusive of quarterly study visits.
Beaumont Hospital and The Royal College of Surgeons in Ireland Clinical Research Centre, Dublin, Ireland.
Patients with an established diagnosis of COPD attending a tertiary medical centre.
Colonisation rate of in patients with COPD and characterisation of serotypes of with correlation to currently available pneumococcal vaccines. Sputum and oropharyngeal swab samples were collected for the isolation of .
Seasonality of colonisation of and its relationship with the incidence of exacerbations of COPD.
was detected in 16 of 417 samples, a colonisation incident rate of 3.8% and in 11 of 133 (8%) patients at least once during the study. The majority of isolates were identified in spring and were non-vaccine serotypes for either the PPV-23 or PCV-13 (63%). The colonisation incident rate of fluctuated over the four seasons with a peak of 6.6% in spring and the lowest rate of 2.2% occurring during winter. Antibiotic use was highest during periods of low colonisation.
There is seasonal variation in colonisation among patients with COPD which may reflect antibiotic use in autumn and winter. The predominance of non-vaccine types suggests that PCV-13 may have limited impact among patients with COPD in Ireland who currently receive PPV-23.
NCT02535546; post-results.
根据疫苗接种状况、抗生素和类固醇的使用情况，对目前接种23价肺炎球菌多糖疫苗（PPV-23）的慢性阻塞性肺疾病（COPD）患者的肺炎球菌定植模式和血清型进行特征描述。调查研究队列中PPV-23和13价肺炎球菌结合疫苗（PCV-13）血清型的流行情况。
一项非干预性、观察性、前瞻性队列研究，随访期为12个月，包括每季度进行一次研究访视。
爱尔兰都柏林的博蒙特医院和爱尔兰皇家外科医学院临床研究中心。
在一家三级医疗中心确诊为COPD的患者。
COPD患者的肺炎球菌定植率，以及与目前可用肺炎球菌疫苗相关的肺炎球菌血清型特征。收集痰液和口咽拭子样本以分离肺炎球菌。
肺炎球菌定植的季节性及其与COPD急性加重发生率的关系。
在417份样本中的16份中检测到肺炎球菌，定植发生率为3.8%，在133名患者中的11名（8%）在研究期间至少检测到一次。大多数肺炎球菌分离株在春季被鉴定出来，并且是PPV-23或PCV-13的非疫苗血清型（63%）。肺炎球菌的定植发生率在四个季节中波动，春季最高，为6.6%，冬季最低，为2.2%。抗生素使用在定植率低的时期最高。
COPD患者的肺炎球菌定植存在季节性变化，这可能反映了秋冬季节的抗生素使用情况。非疫苗血清型的优势表明，PCV-13对目前接种PPV-23的爱尔兰COPD患者的影响可能有限。
NCT02535546；结果公布后。
