Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Internal Medicine Department, Respiratory Unit and Regional Adult Cystic Fibrosis Center, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
Pediatric Section, Department of Health Sciences, University of Florence and Anna Meyer Children's University Hospital, Florence, Italy.
Ther Adv Respir Dis. 2017 Oct;11(10):403-407. doi: 10.1177/1753465817728479. Epub 2017 Aug 31.
The aim of this study was to determine the incidence of exacerbations due to Streptococcus pneumoniae in chronic obstructive pulmonary disease (COPD) patients during stable state.
We conducted a prospective, observational, cohort study including stable COPD patients, who were evaluated at least every 4 months over a 24-month period at the Respiratory Unit of the IRCCS Policlinico Hospital in Milan, Italy, from 2012 to 2015. Sputum samples were collected at enrollment during stable state to evaluate the frequency of S. pneumoniae colonization and in case of an acute exacerbation to evaluate the incidence of pneumococcal infection.
A total of 79 stable patients with moderate to very severe COPD were enrolled. A total of 217 samples were collected, and 27% ( n = 59) of those were positive for S. pneumoniae. A total of four exacerbations due to S. pneumoniae occurred during follow up (0.31 per 100 person/month). Among positive samples of S. pneumoniae, 109 serotypes were identified. The most frequent serotypes in moderate-to-severe COPD patients during both stable state and exacerbation were 19F (12%), 18 (10%), 19A and 9V (9%) and 35 F (7%). Only 32% of COPD patients were effectively vaccinated for S. pneumoniae with PPV23 vaccine.
The most frequent S. pneumoniae serotypes in COPD patients are 19F, 18, 19A, 9V and 35 F, and that almost 50% of S. pneumoniae strains could be covered by PCV13 in adult COPD patients.
本研究旨在确定稳定期慢性阻塞性肺疾病（COPD）患者因肺炎链球菌引起的加重发生率。
我们进行了一项前瞻性、观察性队列研究，纳入了 2012 年至 2015 年期间在意大利米兰 IRCCS 综合医院呼吸科至少每 4 个月接受一次评估的稳定期 COPD 患者。在稳定期采集痰标本以评估肺炎链球菌定植频率，并在急性加重时采集标本以评估肺炎链球菌感染的发生率。
共纳入 79 例中重度 COPD 稳定患者。共采集了 217 个标本，其中 27%（n=59）为肺炎链球菌阳性。在随访期间共发生 4 例肺炎链球菌引起的加重（0.31/100 人/月）。在肺炎链球菌阳性标本中，共鉴定出 109 种血清型。在中重度 COPD 患者的稳定期和加重期，最常见的血清型为 19F（12%）、18（10%）、19A 和 9V（9%）和 35F（7%）。只有 32%的 COPD 患者有效接种了肺炎球菌疫苗（PPV23）。
COPD 患者中最常见的肺炎链球菌血清型为 19F、18、19A、9V 和 35F，而 PCV13 可覆盖近 50%的成人 COPD 患者的肺炎链球菌菌株。
