肺炎链球菌血清型分布及肺炎球菌结合疫苗在中国的潜在影响：系统评价和荟萃分析。
Serotype distribution of Streptococcus pneumoniae and potential impact of pneumococcal conjugate vaccines in China: A systematic review and meta-analysis.
机构信息
a Department of Epidemiology , School of Public Health, Fudan University, Shanghai, China.
b Key Laboratory of Public Health Safety, Ministry of Education , Shanghai , China.
出版信息
Hum Vaccin Immunother. 2018 Jun 3;14(6):1453-1463. doi: 10.1080/21645515.2018.1435224. Epub 2018 Feb 26.
OBJECTIVE
Thirteen-valent pneumococcal conjugate vaccines (PCV13) was licensed for optional use in mainland China since 2017, but the uptake is low. To update the research evidence for the pneumococcal serotype distribution of pre-PCV era and to estimate the potential impact of PCVs, we performed a meta-analysis on the relevant publications concerning the Chinese population.
METHODS
This systematic review and meta-analysis were conducted on the pneumococcal serotype distribution publications in mainland China from 2000 to 2016. The literature was searched in PubMed, Ovid-EMBASE, Web of Science, CNKI and Wanfang. Heterogeneity and publication bias were tested by I, meta-regression, Egger's and Begg's test. The pneumococcal serotype and vaccine serotype coverage rates were pooled using the random-effects model in Stata SE 12.0.
RESULTS
In total, 85 publications were included. Of all 16,945 included pneumococcal isolates, the most common serotypes/serogroups were 19F, 19A, 23F, 14, and 6B, that from children were the same as above, that from adults≥18 years were 19, 3, 6, 23, and 14. Among isolates from children <18 years, the pooled coverage for PCV10 serotypes was 52.3%, that for PCV13 was 68.4% and that for PPSV23 was 65.5%. Regarding individuals ≥18 years, the pooled coverage for PCV10 serotypes was 29.7%, that for PCV13 was 49.5% and that for PPSV23 was 50.7%. Serotype prevalence and vaccine serotype coverage varied by age group, source, and region.
CONCLUSIONS
The most common pneumococcal serotype in mainland China was 19F. The serotype coverage rates of PCV13 and PPSV23 were 50%-68% in mainland China.
目的
十三价肺炎球菌结合疫苗（PCV13）自 2017 年起在中国大陆获准作为非免疫规划疫苗使用，但接种率较低。为了更新 PCV 时代前肺炎球菌血清型分布的研究证据，并评估 PCV 的潜在影响，我们对中国人群相关出版物进行了荟萃分析。
方法
对 2000 年至 2016 年中国大陆肺炎球菌血清型分布的相关文献进行了系统评价和荟萃分析。文献检索来自 PubMed、Ovid-EMBASE、Web of Science、CNKI 和万方。采用 I ² 、meta 回归、Egger 检验和 Begg 检验检测异质性和发表偏倚。采用 Stata SE 12.0 中的随机效应模型对肺炎球菌血清型和疫苗血清型覆盖率进行汇总。
结果
共纳入 85 篇文献。在纳入的 16945 例肺炎球菌分离株中，最常见的血清型/血清群为 19F、19A、23F、14 和 6B，儿童分离株与上述结果相同，成人（≥18 岁）分离株为 19、3、6、23 和 14。在<18 岁的儿童分离株中，PCV10 血清型的覆盖率为 52.3%，PCV13 为 68.4%，PPSV23 为 65.5%。对于≥18 岁的个体，PCV10 血清型的覆盖率为 29.7%，PCV13 为 49.5%，PPSV23 为 50.7%。血清型流行率和疫苗血清型覆盖率因年龄组、来源和地区而异。
结论
中国大陆最常见的肺炎球菌血清型为 19F。PCV13 和 PPSV23 在中国大陆的覆盖率分别为 50%-68%。
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