Jacobs David M, Yung Francine, Hart Emily, Nguyen Melanie N H, Shaver Amy
Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, United States.
Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, United States.
Vaccine. 2017 Oct 27;35(45):6160-6165. doi: 10.1016/j.vaccine.2017.09.050. Epub 2017 Sep 23.
The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in 2010 in the U.S. and its impact on pneumococcal meningitis (PM) is unknown. We assessed the impact of PCV13 on PM hospitalization rates 4years after the vaccine was introduced.
This was a retrospective analysis of the National Inpatient Sample from 2008-2014. Patients with an ICD-9-CM code for PM (320.1) were identified and rates calculated using US Census data as the denominator. Data weights were used to derive national estimates. We examined three time periods: 2008-2009 (late post-PCV7), 2010 (transition year), and 2011-2014 (post-PCV13).
During the study period, there were 10,493 hospitalizations due to PM in the U.S. Overall, PM incidence decreased from 0.62 to 0.38 cases per 100,000 over this time (39% decrease; P<0.01). Among children <2years, the average annualized PM rate decreased by 45% from 2.19 to 1.20 per 100,000 (P=0.10). Annual PM rates decreased in those aged 18-39years (0.25-0.15 cases per 100,000; P=0.02) and 40-64years (0.95-0.54 cases per 100,000; P=0.03). A total of 1016 deaths were due to PM, and the case fatality rate was variable over the study period (8.3%-11.2%; P=0.96).
Following the introduction of PCV13, hospitalization rates for PM decreased significantly with no subsequent improvements in case-fatality rate.
13价肺炎球菌结合疫苗（PCV13）于2010年在美国推出，其对肺炎球菌脑膜炎（PM）的影响尚不清楚。我们评估了PCV13在引入疫苗4年后对PM住院率的影响。
这是一项对2008 - 2014年国家住院患者样本的回顾性分析。确定患有PM的ICD - 9 - CM编码（320.1）的患者，并以美国人口普查数据作为分母计算发病率。数据权重用于得出全国估计数。我们研究了三个时间段：2008 - 2009年（PCV7接种后期）、2010年（过渡年）和2011 - 2014年（PCV13接种后）。
在研究期间，美国有10493例因PM住院。总体而言，在此期间PM发病率从每10万人0.62例降至0.38例（下降39%；P<0.01）。在2岁以下儿童中，年均PM发病率从每10万人2.19例降至1.20例，下降了45%（P = 0.10）。18 - 39岁人群的年PM发病率下降（从每10万人0.25例降至0.15例；P = 0.02），40 - 64岁人群也下降（从每10万人0.95例降至0.54例；P = 0.03）。共有1016例死亡归因于PM，且在研究期间病死率有所变化（8.3% - 11.2%；P = 0.96）。
引入PCV13后，PM住院率显著下降，但病死率随后并无改善。
