National Laboratory for Meningitis and Pneumococcal Infections, Center of Bacteriology, Institute Adolfo Lutz (IAL), São Paulo, State of São Paulo, Brazil.
Faculty of Nursing, Federal University of Goiás, Goiânia, State of Goias, Brazil.
Vaccine. 2018 May 3;36(19):2559-2566. doi: 10.1016/j.vaccine.2018.04.010. Epub 2018 Apr 9.
In March 2010, the 10-valent pneumococcal conjugate vaccine (PCV10) was introduced into the routine immunization program in Brazil. We describe the pneumococcal serotypes that caused invasive pneumococcal diseases (IPD) before and after the introduction of PCV10 using data from a national laboratory-based surveillance system.
We compared the prevalence of vaccine types (VT) and non-vaccine types (NVT) of Streptococcus pneumoniae in three periods, pre-PCV10 (January/2005-December/2009), early post-PCV10 (January/2010-December/2013), and late post-PCV10 (January/2014-December/2015), by episode in meningitis and non-meningitis cases and by age group. Changes in serotype prevalence in the early and late post-PCV10 periods were determined using pre-PCV10 period as a reference.
A total of 8971 IPD isolates from patients aged 2 months to 99 years were analyzed. In the late post-PCV10 period, the VT-IPD reduction in the 2-month to 4-year age group was 83.4% for meningitis and 87.4% for non-meningitis cases; in the age groups 5-17 years, 18-64 years, and ≥65 years, VT declined by 56.1%, 54.1%, and 47.4%, respectively, in meningitis cases, and by 60.9%, 47.7%, and 53.4%, respectively, in non-meningitis cases. NVT-IPD increased throughout the study period, driven mainly by serotypes 3, 6C, and 19A, which remained the predominant types causing IPD in the late post-PCV10 period.
We observed direct and indirect PCV10 protection against IPD caused by VT and a shift in the distribution of serotypes 5 years after the introduction of PCV10. Continued IPD surveillance is needed to evaluate the sustainability of the high prevalence of serotypes 3, 6C, and 19A, which were not included in PCV10.
2010 年 3 月，10 价肺炎球菌结合疫苗（PCV10）被引入巴西常规免疫规划。我们使用国家基于实验室的监测系统的数据，描述了 PCV10 引入前后侵袭性肺炎球菌病（IPD）的肺炎球菌血清型。
我们比较了三个时期的疫苗类型（VT）和非疫苗类型（NVT）的流行情况，即 PCV10 之前（2005 年 1 月至 2009 年 12 月）、PCV10 早期（2010 年 1 月至 2013 年 12 月）和 PCV10 后期（2014 年 1 月至 2015 年 12 月），分别按脑膜炎和非脑膜炎病例的发病情况和年龄组进行比较。使用 PCV10 之前的时期作为参考，确定了 PCV10 早期和后期流行情况的变化。
共分析了 8971 例 2 个月至 99 岁患者的 IPD 分离株。在 PCV10 后期，2 个月至 4 岁年龄组的 VT-IPD 下降幅度在脑膜炎病例中为 83.4%，在非脑膜炎病例中为 87.4%；在 5-17 岁、18-64 岁和≥65 岁年龄组中，脑膜炎病例中 VT 下降了 56.1%、54.1%和 47.4%，非脑膜炎病例中下降了 60.9%、47.7%和 53.4%。整个研究期间，NVT-IPD 呈上升趋势，主要由血清型 3、6C 和 19A 驱动，这些血清型仍然是 PCV10 引入后后期引起 IPD 的主要类型。
我们观察到针对 VT 引起的 IPD 的直接和间接 PCV10 保护作用，以及在引入 PCV10 5 年后血清型分布的转变。需要继续进行 IPD 监测，以评估血清型 3、6C 和 19A 的高流行率的可持续性，这些血清型未包含在 PCV10 中。
