Takeda Hiroaki, Sato Chisa, Bin Chang, Nishidzuka Midori, Watanabe Mari, Yamamoto Tomoka, Suzuki Hiroki, Oishi Kazunori, Tsuchida Fumihiro
Department of Respiratory Medicine, Yamagata Saisei Hospital, Yamagata, Japan.
Department of Bacteriology 1, National Institute of Infectious Diseases, Tokyo, Japan.
J Glob Infect Dis. 2019 Jan-Mar;11(1):30-35. doi: 10.4103/jgid.jgid_167_17.
Although the incidence of invasive pneumococcal infections in children has decreased since the introduction of pneumococcal conjugate vaccines (PCVs), the appearance of serotype replacements has continued to increase.
We examined the frequency of serotype replacements in adult cases of pneumococcal pneumonia. Furthermore, the transition in the coverage of vaccine serotypes (VTs) to non-VTs (NVTs) was also examined.
We investigated all confirmed cases of pneumococcal pneumonia in 303 adult patients admitted to Yamagata Saisei Hospital between April 2006 and March 2015.
Pneumococcal serotypes were determined by testing for a specific type of antiserum using the capsular swelling method.
Chi-square tests were used to compare patient characteristics.
Annually, the number of admitted patients ranged from 24 to 43, with most of them being men (64.7% of the total patient cohort). Although many cases involved some underlying conditions, the rate of pneumococcal vaccination remained low. The average rate of multigeneration housing was high (37.6%). The rates of pneumococcal vaccine coverage declined since 2013 (7-valent PCV (PCV7), 18.5%; PCV13, 59.3%; and 23-pneumococcal polysaccharide vaccine (PPSV23), 66.7%) and were <50% for each vaccine (PCV7, 4.7%; PCV13, 32.6%; and PPSV23, 48.8%) in 2015. In addition, the VTs were replaced with NVTs in 2015 (48.8% vs. 51.2%).
The frequency of NVTs in adult pneumococcal pneumonia increased in 2013, with the frequency exceeding that of the vaccine forms in 2015. Regular PCV vaccination of children and multigeneration housing seem to be associated with this reversed trend.
尽管自引入肺炎球菌结合疫苗（PCV）以来，儿童侵袭性肺炎球菌感染的发病率有所下降，但血清型替换现象仍持续增加。
我们研究了成人肺炎球菌肺炎病例中血清型替换的频率。此外，还研究了疫苗血清型（VTs）向非疫苗血清型（NVTs）的覆盖转变情况。
我们调查了2006年4月至2015年3月期间入住山形再生医院的303例成年患者中所有确诊的肺炎球菌肺炎病例。
采用荚膜肿胀法检测特定类型的抗血清来确定肺炎球菌血清型。
采用卡方检验比较患者特征。
每年收治的患者人数在24至43人之间，其中大多数为男性（占患者总数的64.7%）。尽管许多病例伴有一些基础疾病，但肺炎球菌疫苗接种率仍然很低。多代同堂居住的平均比例很高（37.6%）。自2013年以来，肺炎球菌疫苗的覆盖率有所下降（7价PCV（PCV7）为18.5%；PCV13为59.3%；23价肺炎球菌多糖疫苗（PPSV23）为66.7%），2015年每种疫苗的覆盖率均低于50%（PCV7为4.7%；PCV13为32.6%；PPSV23为48.8%）。此外，2015年VTs被NVTs取代（48.8%对51.2%）。
2013年成人肺炎球菌肺炎中NVTs的频率增加，2015年其频率超过了疫苗型。儿童定期接种PCV疫苗和多代同堂居住似乎与这种相反的趋势有关。
