Haji Tahereh, Byrne Adam, Kovesi Tom
College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada.
Department of Pediatrics, Children's Hospital of Eastern Ontario, 401 Smyth Rd., Ottawa, ON K1H 8L1, Canada.
Children (Basel). 2018 Mar 3;5(3):36. doi: 10.3390/children5030036.
Following the introduction of 7-valent pneumococcal vaccine (PCV7), while overall rates of invasive pneumococcal disease and pneumococcal pneumonia in children declined, rates of empyema increased. We examined changes in the incidence of hospitalization for pediatric complicated pneumonia (PCOMP) in Eastern Ontario, Canada, particularly since the introduction of the 13-valent vaccine (PCV13). A retrospective chart review was carried out evaluating previously healthy children admitted with PCOMP, which included empyema, parapneumonic effusion, necrotizing pneumonia, and lung abscess between 2002 and 2015. Three-hundred seventy-one children were included. Subjects had a median age of four years, and 188/370 (50.8%) required a chest tube. Admission rates changed markedly during this time period. The number of admissions per year rose most sharply between 2009 and 2012, corresponding to the period following introduction of PCV7 and then the occurrence of pandemic influenza A (H1N1). In children who likely received PCV13, the incidence of PCOMP returned to approximately pre-PCV7 levels. In contrast, rates of PCOMP in older children (who would not have received PCV13) remained elevated during the post-PCV13 time period. While rates of PCOMP, particularly in older children, remain elevated following the introduction of PCV13, this might be expected to resolve with more widespread vaccine coverage with PCV13 and herd immunity.
在引入7价肺炎球菌疫苗（PCV7）后，儿童侵袭性肺炎球菌疾病和肺炎球菌肺炎的总体发病率下降，但脓胸发病率上升。我们研究了加拿大安大略省东部儿童复杂性肺炎（PCOMP）住院发病率的变化，特别是自引入13价疫苗（PCV13）以来。进行了一项回顾性病历审查，评估2002年至2015年间因PCOMP入院的既往健康儿童，其中包括脓胸、肺炎旁胸腔积液、坏死性肺炎和肺脓肿。纳入了371名儿童。受试者的中位年龄为4岁，188/370（50.8%）需要放置胸管。在此期间，入院率发生了显著变化。每年的入院人数在2009年至2012年间上升最为急剧，这与引入PCV7后紧接着甲型H1N1流感大流行的时期相对应。在可能接种了PCV13的儿童中，PCOMP的发病率恢复到了大约PCV7接种前的水平。相比之下，年龄较大儿童（未接种PCV13）的PCOMP发病率在PCV13接种后的时期仍然居高不下。虽然在引入PCV13后，PCOMP的发病率，特别是年龄较大儿童的发病率仍然居高不下，但随着PCV13疫苗接种范围的扩大和群体免疫的实现，这种情况可能会得到缓解。
