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在哥伦比亚波哥大,10 价肺炎球菌结合疫苗(PCV10)引入后,血清型 19A(Spn19A)成为儿童侵袭性肺炎球菌病的主要病因。

Emergence of serotype 19A (Spn19A) in the pediatric population in Bogotá, Colombia as the main cause of invasive pneumococcal disease after the introduction of PCV10.

机构信息

Universidad Nacional de Colombia , Bogotá, Colombia.

Fundación HOMI - Hospital Pediátrico de la Misericordia , Bogotá, Colombia.

出版信息

Hum Vaccin Immunother. 2020 Sep 1;16(9):2300-2306. doi: 10.1080/21645515.2019.1710411. Epub 2020 Feb 20.

Abstract

: With the use of pneumococcal conjugate vaccines(PCV), the behavior of invasive pneumococcal disease(IPD) has changed relative to serotype distribution. The introduction of these vaccines in national immunization programs has reduced the incidence of IPD, with a marked decrease in the circulation of the serotypes included in the vaccine used in each country. However, the subsequent emergence of other serotypes not included in the vaccine, such 19A in case of PCV7 and PCV10, has been documented. : This was case series study (2008-2017) in pediatric patients admitted to 10 hospitals in Bogota who were diagnosed with IPD. It was conducted during the transitional period of implementing the PCV10 vaccine in Colombia in 2012. Cases of bacteremic pneumococcal pneumonia, meningitis, primary bacteremia and osteoarticular infection were included. A descriptive analysis of the demographic, clinical and laboratory variables of patients with IPD by Spn19A, its trend over time, profiles of antimicrobial susceptibility and clinical outcomes was performed. : There were 463 cases of IPD, 315(68%) with known serotypes. The prevalence of IPD by Spn19A was 17.7%(56 cases), tending to increase over time. During 2008-2011, the prevalence was 4.4%, and during 2014-2017, it was 32.4%, The most frequent diagnosis was pneumonia(80.4%). In nonmeningeal isolates, 39.6% were not susceptible to penicillin. An increase in the resistance was observed over time. : Spn19A is a prevalent cause of IPD in the pediatric population of the analyzed cohort, with an increasing trend of this serotype during the surveillance period after the introduction of PCV10, being the most common serotype identified in recent years.

摘要

: 由于使用了肺炎球菌结合疫苗(PCV),侵袭性肺炎球菌病(IPD)的行为相对于血清型分布发生了变化。这些疫苗在国家免疫计划中的引入降低了 IPD 的发病率,各国使用的疫苗中包含的血清型的循环明显减少。然而,随后出现了其他未包含在疫苗中的血清型,例如 PCV7 和 PCV10 中的 19A。 : 这是一项病例系列研究(2008-2017 年),纳入了在哥伦比亚首都波哥大的 10 家医院住院的儿科患者,这些患者被诊断为 IPD。该研究是在 2012 年哥伦比亚实施 PCV10 疫苗的过渡时期进行的。纳入的病例包括菌血症性肺炎球菌肺炎、脑膜炎、原发性菌血症和骨关节炎感染。对患者的人口统计学、临床和实验室变量进行了描述性分析,包括 Spn19A、其随时间的趋势、抗菌药物敏感性谱和临床结局。 : 共发生了 463 例 IPD,其中 315 例(68%)已知血清型。Spn19A 导致的 IPD 患病率为 17.7%(56 例),呈逐渐上升趋势。2008-2011 年期间,患病率为 4.4%,而 2014-2017 年期间,患病率为 32.4%。最常见的诊断是肺炎(80.4%)。在非脑膜炎分离株中,39.6%对青霉素不敏感。耐药性呈上升趋势。 : Spn19A 是分析队列中儿科人群 IPD 的常见原因,在 PCV10 引入后的监测期间,该血清型呈上升趋势,是近年来最常见的血清型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/762b/7553689/3a67d666a585/KHVI_A_1710411_F0001_C.jpg

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