Wyllie Anne L, Warren Joshua L, Regev-Yochay Gili, Givon-Lavi Noga, Dagan Ron, Weinberger Daniel M
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA.
Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA.
Clin Infect Dis. 2021 Jun 1;72(11):e768-e775. doi: 10.1093/cid/ciaa1480.
The importance of specific serotypes causing invasive pneumococcal disease (IPD) differs by age. Data on pneumococcal carriage in different age groups, along with data on serotype-specific invasiveness, could help explain these age-related patterns and their implications for vaccination.
Using pneumococcal carriage and disease data from Israel, we evaluated the association between serotype-specific IPD in adults and serotype-specific carriage prevalence among children in different age categories, while adjusting for serotype-specific invasiveness. We estimated carriage prevalence using different age groupings that were selected a priori. The Deviance Information Criterion was used to determine which age groupings of carriage data best fit the adult IPD data. Serotype-specific disease patterns were further evaluated by stratifying IPD data by comorbidity status.
The relative frequency of serotypes causing IPD differed between adults and children, and also differed between older and younger adults and between adults with and without comorbidities. Serotypes overrepresented as causes of IPD in adults were more commonly carried in older children compared with younger children. In line with this, the serotype-specific frequency of carriage in older children, rather than infants, best correlated with serotype-specific IPD in adults.
These analyses demonstrate that the serotype patterns in carriage in older children, rather than infants, are best correlated with disease patterns in adults. This might suggest these older children are more influential for disease patterns in adults. These insights could help in optimizing vaccination strategies to reduce disease burden across all ages.
引起侵袭性肺炎球菌疾病（IPD）的特定血清型的重要性因年龄而异。不同年龄组的肺炎球菌携带数据以及血清型特异性侵袭性数据，有助于解释这些与年龄相关的模式及其对疫苗接种的影响。
利用以色列的肺炎球菌携带和疾病数据，我们评估了成人中血清型特异性IPD与不同年龄类别儿童中血清型特异性携带率之间的关联，同时对血清型特异性侵袭性进行了校正。我们使用事先选定的不同年龄分组来估计携带率。采用偏差信息准则来确定携带数据的哪些年龄分组最适合成人IPD数据。通过按合并症状态对IPD数据进行分层，进一步评估血清型特异性疾病模式。
引起IPD的血清型的相对频率在成人和儿童之间有所不同，在老年和年轻成人之间以及有合并症和无合并症的成人之间也有所不同。与年幼儿童相比，在较大儿童中更常见于成人中作为IPD病因的血清型。与此一致的是，较大儿童而非婴儿中血清型特异性携带频率与成人中血清型特异性IPD最相关。
这些分析表明，较大儿童而非婴儿的携带血清型模式与成人疾病模式最相关。这可能表明这些较大儿童对成人疾病模式的影响更大。这些见解有助于优化疫苗接种策略，以减轻所有年龄段的疾病负担。
