2001 - 2016年德国实施常规儿童免疫接种后的侵袭性感染情况
Invasive Infections in Germany After the Introduction of Routine Childhood Immunization, 2001-2016.
作者信息
Takla Anja, Schönfeld Viktoria, Claus Heike, Krone Manuel, An der Heiden Matthias, Koch Judith, Vogel Ulrich, Wichmann Ole, Lâm Thiên-Trí
机构信息
Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany.
Institute for Hygiene and Microbiology, National Reference Laboratory for Meningococci and Haemophilus influenzae, University of Wuerzburg, Wuerzburg, Germany.
出版信息
Open Forum Infect Dis. 2020 Sep 18;7(10):ofaa444. doi: 10.1093/ofid/ofaa444. eCollection 2020 Oct.
BACKGROUND
(Hi) serotype b (Hib) vaccination was introduced in Germany in 1990. This study presents a comprehensive overview on the burden of invasive Hi infections for 2001-2016, including serotype distribution and ampicillin resistance.
METHODS
Nationwide data from statutory disease surveillance (2001-2016) were linked with laboratory surveillance data (2009-2016). Besides descriptive epidemiology, statistical analyses included multiple imputation to estimate secular trends.
RESULTS
In 2001-2016, 4044 invasive Hi infections were reported. The mean incidence was 3.0 per million inhabitants, higher in males (3.2 vs 2.9 in females) and in the age groups <1 year (15.2) and ≥80 years (15.5). Nontypeable Hi (NTHi) caused 81% (n = 1545) of cases in 2009-2016. Of capsulated cases, 69% were serotype f and 17% serotype b. Of Hib cases eligible for vaccination, 10% (3/29) were fully vaccinated. For 2009-2016, significant increasing trends were observed for NTHi and Hif infections in the age groups <5 years and ≥60 years and for ampicillin resistance in NTHi.
CONCLUSIONS
This is one of the most comprehensive Hi data analyses since the introduction of Hib vaccines. NTHi and Hif cause an increasing disease burden among elderly patients and infants. Ampicillin resistance in NTHi must be considered in the treatment of invasive Hi infections.
背景
1990年b型流感嗜血杆菌（Hib）疫苗在德国开始使用。本研究全面概述了2001 - 2016年侵袭性流感嗜血杆菌感染的负担，包括血清型分布和氨苄西林耐药情况。
方法
将全国法定疾病监测数据（2001 - 2016年）与实验室监测数据（2009 - 2016年）相联系。除描述性流行病学外，统计分析包括多重填补法以估计长期趋势。
结果
2001 - 2016年，共报告4044例侵袭性流感嗜血杆菌感染。平均发病率为每百万居民3.0例，男性发病率较高（男性为3.2，女性为2.9），年龄<1岁组（15.2）和≥80岁组（15.5）发病率更高。2009 - 2016年，不可分型流感嗜血杆菌（NTHi）导致81%（n = 1545）的病例。在有荚膜的病例中，69%为f血清型，17%为b血清型。在符合疫苗接种条件的Hib病例中，10%（3/29）已完全接种疫苗。2009 - 2016年，<5岁和≥60岁年龄组的NTHi和Hif感染以及NTHi的氨苄西林耐药性呈显著上升趋势。
结论
这是自Hib疫苗引入以来最全面的流感嗜血杆菌数据分析之一。NTHi和Hif在老年患者和婴儿中导致的疾病负担不断增加。在治疗侵袭性流感嗜血杆菌感染时，必须考虑NTHi对氨苄西林的耐药性。
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