Sakata Hiroshi, Sato Yoshitake, Toyonaga Yoshikiyo, Hanaki Hideaki
Department of Pediatrics, Asahikawa Kosei Hospital, Asahikawa, Hokkaido, Japan.
Department of Pediatrics, Subaru Health Insurance Society Ota Memorial Hospital, Ota, Gunma, Japan.
Pediatr Int. 2018 Jan;60(1):52-56. doi: 10.1111/ped.13386. Epub 2017 Oct 3.
This study examined the trends for the serotypes of S. pneumoniae that have caused infections before (2010) and after (2012) the introduction of PCV-7 in Japan.
We examined 458 strains of Streptococcus pneumoniae obtained from 22 pediatric institutions throughout Japan from January to June 2010 (immediately after the introduction of the seven-valent pneumococcal conjugate vaccine [PCV-7]), and 370 strains obtained from 19 institutions from January to June 2012 (after PCV-7 became widely used). The samples were collected from children aged 0-14 years with conditions such as respiratory tract infections (upper airway inflammation, bronchitis, and pneumonia), meningitis, and sepsis.
The most frequent serotype in the 2010 strains was 19F (17.3%), followed by 6B (16.8%), and 23F (15.1%). The most frequent serotype in the 2012 strains was 6C (10.0%), followed by 19F (9.7%), 15A (8.9%) and 15B (8.9%), indicating a significant change in the distribution. The serotypes contained in PCV-7 were detected in 280 strains (61.1%) in 2010 and in 81 strains (21.9%) in 2012 (P < 0.01). The serotypes contained in PCV-13 were detected in 356 strains (77.7%) in 2010 and in 146 strains (39.5%) in 2012 (P < 0.01). A total of 129 subjects who had not been vaccinated with PCV-7 and 127 subjects who had been vaccinated with PCV-7 at least once, were compared with regard to the 2012 strains. The serotypes contained in PCV-7 were found in 21 strains (16.5%) in those who had been vaccinated and in 37 strains (28.7%) in those who had not been vaccinated (P < 0.05).
The increased use of PCV-7 led to decreases in the serotypes contained in PCV-13 and increases in the serotypes not contained in PCV-13, suggesting serotype replacement.
本研究调查了在日本引入7价肺炎球菌结合疫苗（PCV-7）之前（2010年）和之后（2012年）引起感染的肺炎链球菌血清型的变化趋势。
我们检测了2010年1月至6月（7价肺炎球菌结合疫苗[PCV-7]引入后不久）从日本各地22家儿科机构收集的458株肺炎链球菌，以及2012年1月至6月（PCV-7广泛使用后）从19家机构收集的370株肺炎链球菌。样本取自0至14岁患有呼吸道感染（上呼吸道炎症、支气管炎和肺炎）、脑膜炎和败血症等疾病的儿童。
2010年菌株中最常见的血清型是19F（17.3%），其次是6B（16.8%）和23F（15.1%）。2012年菌株中最常见的血清型是6C（10.0%），其次是19F（9.7%）、15A（8.9%）和15B（8.9%），表明分布有显著变化。2010年在PCV-7中的血清型在280株菌株（61.1%）中被检测到，2012年在81株菌株（21.9%）中被检测到（P<0.01）。2010年在PCV-13中的血清型在356株菌株（77.7%）中被检测到，2012年在146株菌株（39.5%）中被检测到（P<0.01）。将129名未接种PCV-7的受试者和127名至少接种过一次PCV-7的受试者就2012年的菌株进行比较。在接种过疫苗的受试者中，PCV-7中的血清型在21株菌株（16.5%）中被发现，在未接种疫苗的受试者中，在37株菌株（28.7%）中被发现（P<0.05）。
PCV-7使用的增加导致PCV-13中所含血清型减少，PCV-13中未包含的血清型增加，提示血清型替换。
