Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
Department of Clinical Microbiology Laboratory, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China.
Vaccine. 2020 Nov 17;38(49):7858-7864. doi: 10.1016/j.vaccine.2020.10.005. Epub 2020 Oct 21.
Streptococcus pneumoniae can cause many infectious diseases among children, and relevant vaccines have not been scheduled into the National Immunization Program in China. The serotype distribution of Streptococcus pneumoniae is essential information used to evaluate the value of pneumococcal vaccines and formulate immunization strategies.
Streptococcus pneumoniae isolates, identified as the disease pathogens, were collected from children hospitalized in Beijing Children's Hospital from 2013 to 2019. The serotype was detected by the Quellung reaction.
A total of 903 isolates of Streptococcus pneumoniae were collected, among which 809 were from non-invasive infections and 94 were from invasive infections. The non-invasive isolates were mainly isolated from respiratory secretions (49.4%) and bronchoalveolar lavage fluid (38.9%), while invasive isolates were from venous blood (5.4%), cerebrospinal fluid (2.8%) and pleural effusion (2.8%). The leading serotypes were 19F (36.0%), 19A (13.6%), 23F (9.4%), 14 (8.9%), 6A (6.9%), and 6B (5.3%). The overall coverage rates of 10-, 13-, 15-, 20-valent pneumococcal conjugate vaccines (PCV10, PCV13, PCV15, PCV20) and 23-valent pneumococcal polysaccharide vaccine (PPV23) as well as Pneumosil (a 10-valent pneumococcal conjugate vaccine) were 61.6%, 83.2%, 83.4%, 88.0%, 82.4% and 81.6%, respectively. The coverage rates of PCV13, PCV15 and PPV23 in isolates from invasive infections were significantly higher than those from non-invasive infections. The coverage rates of Pneumosil, either on the whole or among different age groups or different infections, were significantly higher than those of PCV10.
Serotypes 19F, 19A, 23F, 14, 6A and 6B were the most common types among the isolates. As for pneumococcal vaccines available now, the coverage rate of PCV13 was high, especially in isolates from invasive infections. The promotion of PCV13 or further high valent vaccines might be of greater benefit in preventing pneumococcal infections than other pneumococcal vaccines in children.
肺炎链球菌可引起儿童多种感染性疾病，相关疫苗尚未纳入中国国家免疫规划。肺炎链球菌血清型分布是评估肺炎球菌疫苗价值和制定免疫策略的重要信息。
收集 2013 年至 2019 年北京儿童医院住院患儿感染的肺炎链球菌分离株，采用胶乳凝集试验进行血清型检测。
共收集 903 株肺炎链球菌分离株，其中非侵袭性感染 809 株，侵袭性感染 94 株。非侵袭性分离株主要来自呼吸道分泌物（49.4%）和支气管肺泡灌洗液（38.9%），侵袭性分离株来自静脉血（5.4%）、脑脊液（2.8%）和胸腔积液（2.8%）。主要血清型为 19F（36.0%）、19A（13.6%）、23F（9.4%）、14（8.9%）、6A（6.9%）和 6B（5.3%）。10 价、13 价、15 价、20 价肺炎球菌结合疫苗（PCV10、PCV13、PCV15、PCV20）和 23 价肺炎球菌多糖疫苗（PPV23）以及沛儿（10 价肺炎球菌结合疫苗）的总体覆盖率分别为 61.6%、83.2%、83.4%、88.0%、82.4%和 81.6%。侵袭性感染分离株中 PCV13、PCV15 和 PPV23 的覆盖率明显高于非侵袭性感染分离株。沛儿在整体以及不同年龄组或不同感染类型中的覆盖率均明显高于 PCV10。
19F、19A、23F、14、6A 和 6B 是分离株中最常见的血清型。目前可用的肺炎球菌疫苗中，PCV13 的覆盖率较高，尤其是侵袭性感染分离株。与其他肺炎球菌疫苗相比，推广 PCV13 或进一步的高价疫苗可能更有益于预防儿童肺炎球菌感染。
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