Johansson Kostenniemi Urban, Palm Jessica, Silfverdal Sven-Arne
Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
Department of Clinical Microbiology, Infectious Diseases, Umeå University, Umeå, Sweden.
Acta Paediatr. 2018 Sep;107(9):1601-1609. doi: 10.1111/apa.14345. Epub 2018 Apr 26.
Streptococcus pneumoniae commonly causes respiratory tract infections including acute otitis media and pneumonia. In this study, we evaluated the impact of general infant pneumococcal vaccination, introduced in Sweden in 2009, on respiratory tract infections.
We studied the incidence of respiratory tract infections and antibiotic consumption in Västerbotten County, Sweden, during 2005-2014 using the County Council's diagnosis register.
Comparing the prevaccination period of 2005-2008 to 2014, the incidences of all-cause acute otitis media decreased significantly in children aged 0-4 and five years to 17 years, by 41.5% and 20.9%, respectively. In addition, we also noted significant reductions in sinusitis and other upper respiratory tract infections, and some reductions in adults. Antibiotic consumption for upper respiratory tract infections decreased by 37.1%, with the largest decrease occurring in children aged 0-4 years. For pneumonia, the incidence significantly decreased by 28.6% for children aged 0-4 years, with no significant changes in older children or adults.
Pneumococcal vaccination was followed by reduced incidence of upper respiratory tract infections and antibiotic consumption in vaccinated children, with some indications of possible herd immunity. For pneumonia, a major reduction was noted limited to the youngest children.
肺炎链球菌通常会引发包括急性中耳炎和肺炎在内的呼吸道感染。在本研究中，我们评估了2009年在瑞典推行的普通婴儿肺炎球菌疫苗接种对呼吸道感染的影响。
我们利用郡议会的诊断登记册，研究了2005年至2014年期间瑞典韦斯特博滕郡呼吸道感染的发病率和抗生素使用情况。
将2005 - 2008年的疫苗接种前时期与2014年进行比较，0至4岁儿童以及5至17岁儿童的全因急性中耳炎发病率显著下降，分别下降了41.5%和20.9%。此外，我们还注意到鼻窦炎和其他上呼吸道感染显著减少，成人中也有一定程度的减少。上呼吸道感染的抗生素使用量下降了37.1%，降幅最大的是0至4岁儿童。对于肺炎，0至4岁儿童的发病率显著下降了28.6%，年龄较大的儿童和成人则无显著变化。
接种肺炎球菌疫苗后，接种疫苗的儿童上呼吸道感染发病率和抗生素使用量降低，有迹象表明可能存在群体免疫。对于肺炎，主要降幅仅限于最小的儿童。
