阿穆尔河流域严重洪灾条件下儿童肺炎球菌感染的疫苗预防

Vaccine Prophylaxis of Pneumococcal Infections in Children under Conditions of Severe Flood in the Amur River Basin.

作者信息

Chuchalin Aleksandr G, Onishchenko Gennadiy G, Kolosov Victor P, Kurganova Olga P, Zaitseva Tatiana A, Manakov Leonid G, Kholodok Galina N, Perelman Juliy M, Kozlov Roman S, Ivakhnishina Natalia M, Trotsenko Olga E, Bondarenko Albina P

机构信息

Department of Hospital Therapy, Pediatric Faculty, Pirogov Russian National Research Medical University, Moscow 117997, Russia.

Russian Academy of Sciences, Moscow 119991, Russia.

出版信息

Interdiscip Perspect Infect Dis. 2019 Feb 18;2019:5467275. doi: 10.1155/2019/5467275. eCollection 2019.

DOI:10.1155/2019/5467275

PMID:30906320

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6398015/

Abstract

BACKGROUND

Pneumococcal infection being one of the dominant causes of acute respiratory diseases and exacerbation of chronic ones is a serious problem for human health and society. The flood in the Amur river basin in the summer of 2013 created a special zone and risk conditions for the formation of respiratory pathology in the Far-Eastern region of Russia. We aimed to give clinical and epidemiological assessment of the effectiveness of vaccination programs of respiratory viral and pneumococcal infections and generalization of regional experience in the organization of a set of measures aimed at their prevention in the postflood period in the Far-Eastern region.

METHODS

The monitoring program includes children aged 2 to 5 years in the amount of 4988 with risk factors for pneumococcal infection. The pneumococcal conjugate vaccine was used for immunization. Data on the incidence of ARVI and pneumonia in children in pre- and postvaccination periods were to be recorded. The indicators and special criteria were used to assess the effectiveness of vaccination. To study the circulation of serovariants of pneumococcus in inflammatory diseases of the respiratory tract and nasopharyngeal carrier, bacteriological and molecular genetic methods (RT-PCR in the mode of multiprime detection) were used.

RESULTS

Differences in the frequency and range of serovariants of circulating isolates of pneumococcus in the postvaccinal period and in unvaccinated children, elimination of a number of serotypes, and appearance of circulation of nonvaccinated strains were revealed. The incidence of acute respiratory diseases and pneumonia among the vaccinated population for 2 years in the region decreased by 2.5 times. The coefficient of effectiveness of vaccination according to the indicator of morbidity of children with pneumonia reaches 75-100% with direct dependence on the age of children (r=0.98).

CONCLUSION

Comparative statistical analysis revealed a high degree of effectiveness of regional programs with the methods of immunoprophylaxis of pneumococcal infections.

摘要

背景

肺炎球菌感染是急性呼吸道疾病的主要病因之一，也是慢性呼吸道疾病恶化的原因，对人类健康和社会构成严重问题。2013年夏季阿穆尔河流域的洪水在俄罗斯远东地区形成了一个特殊区域，并为呼吸道疾病的形成创造了风险条件。我们旨在对呼吸道病毒和肺炎球菌感染疫苗接种计划的有效性进行临床和流行病学评估，并总结该地区在洪水后时期组织一系列预防措施方面的经验。

方法

监测计划包括4988名2至5岁有肺炎球菌感染风险因素的儿童。使用肺炎球菌结合疫苗进行免疫接种。记录接种疫苗前后儿童急性呼吸道感染和肺炎的发病率数据。使用指标和特殊标准评估疫苗接种的有效性。为研究肺炎球菌血清型在呼吸道炎症疾病和鼻咽部带菌者中的传播情况，采用了细菌学和分子遗传学方法（多重引物检测模式下的逆转录聚合酶链反应）。

结果

揭示了疫苗接种后时期与未接种疫苗儿童中肺炎球菌循环分离株血清型的频率和范围差异，一些血清型的消除，以及未接种疫苗菌株的循环出现。该地区接种疫苗人群中急性呼吸道疾病和肺炎的发病率在2年内下降了2.5倍。根据肺炎患儿发病率指标计算的疫苗接种有效系数达到75%-100%，且与儿童年龄直接相关（r=0.98）。