McAuliffe Gary N, Taylor Susan L, Drinković Dragana, Roberts Sally A, Wilson Elizabeth M, Best Emma J
From the *Microbiology Department, Auckland City Hospital, †Microbiology Department, Middlemore Hospital, ‡Microbiology Department, North Shore Hospital, and §Department of Paediatric Infectious Diseases, Starship Children's Hospital, Auckland, New Zealand.
Pediatr Infect Dis J. 2018 Jan;37(1):e1-e5. doi: 10.1097/INF.0000000000001706.
In July 2014, New Zealand introduced universal infant vaccination with RotaTeq (Merk & Co.) administered as 3 doses at 6 weeks, 3 and 5 months of age. We sought to assess the impact of rotavirus vaccination on gastroenteritis (GE) hospitalizations in the greater Auckland region and analyze changes in rotavirus testing in the period around vaccine introduction.
Hospitalizations, laboratory testing rates and methods were compared between the pre-vaccine period (2009-2013), post-vaccine period (January 2015 to December 2015) and year of vaccine introduction (2014).
There was a 68% decline in rotavirus hospitalizations of children <5 years of age after vaccine introduction (from 258/100,000 to 83/100,000) and a 17% decline in all-cause gastroenteritis admissions (from 1815/100,000 to 1293/100,000). Reductions were also seen in pediatric groups too old to have received vaccine. Despite these changes, rotavirus testing rates in our region remained static in the year after vaccine introduction compared with the 2 prior years, and after vaccine introduction, we observed a high rate of false positives 19/58 (33%) in patients with reactive rotavirus tests.
Rotavirus vaccine has had a significant early impact on gastroenteritis hospitalizations for children in the Auckland region. However, continued rotavirus testing at pre-vaccine rates risks generating false positive results. Laboratories and clinicians should consider reviewing their testing algorithms before vaccine introduction.
2014年7月，新西兰引入了Rotarix（默克公司生产）的通用婴儿疫苗，在6周、3个月和5个月龄时分3剂接种。我们试图评估轮状病毒疫苗对大奥克兰地区胃肠炎（GE）住院治疗的影响，并分析疫苗引入前后期间轮状病毒检测的变化。
比较了疫苗接种前时期（2009 - 2013年）、疫苗接种后时期（2015年1月至2015年12月）和疫苗引入年份（2014年）的住院情况、实验室检测率和方法。
疫苗引入后，5岁以下儿童轮状病毒住院率下降了68%（从每10万人258例降至每10万人83例），全因胃肠炎入院率下降了17%（从每10万人1815例降至每10万人1293例）。在因年龄太大而未接种疫苗的儿童群体中也观察到了下降。尽管有这些变化，但与前两年相比，我们地区在疫苗引入后的一年中轮状病毒检测率保持不变，并且在疫苗引入后，我们观察到轮状病毒检测呈反应性的患者中假阳性率很高，为19/58（33%）。
轮状病毒疫苗对奥克兰地区儿童的胃肠炎住院治疗产生了显著的早期影响。然而，以疫苗接种前的速率继续进行轮状病毒检测有可能产生假阳性结果。实验室和临床医生应在疫苗引入前考虑审查其检测算法。
