抗生素使用与疫苗抗体水平。
Antibiotic Use and Vaccine Antibody Levels.
机构信息
Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York.
School of Mathematical Sciences, College of Science, Rochester Institute of Technology, Rochester, New York.
出版信息
Pediatrics. 2022 May 1;149(5). doi: 10.1542/peds.2021-052061.
BACKGROUND
The majority of children are prescribed antibiotics in the first 2 years of life while vaccine-induced immunity develops. Researchers have suggested a negative association of antibiotic use with vaccine-induced immunity in adults, but data are lacking in children.
METHODS
From 2006 to 2016, children aged 6 to 24 months were observed in a cohort study. A retrospective, unplanned secondary analysis of the medical record regarding antibiotic prescriptions and vaccine antibody measurements was undertaken concurrently. Antibody measurements relative to diphtheria-tetanus-acellular pertussis (DTaP), inactivated polio (IPV), Haemophilus influenzae type b (Hib), and pneumococcal conjugate (PCV) vaccines were made.
RESULTS
In total, 560 children were compared (342 with and 218 without antibiotic prescriptions). Vaccine-induced antibody levels to several DTaP and PCV antigens were lower (P < .05) in children given antibiotics. A higher frequency of vaccine-induced antibodies below protective levels in children given antibiotics occurred at 9 and 12 months of age (P < .05). Antibiotic courses over time was negatively associated with vaccine-induced antibody levels. For each antibiotic course the child received, prebooster antibody levels to DTaP antigens were reduced by 5.8%, Hib by 6.8%, IPV by 11.3%, and PCV by 10.4% (all P ≤ .05), and postbooster antibody levels to DTaP antigens were reduced by 18.1%, Hib by 21.3%, IPV by 18.9%, and PCV by 12.2% (all P < .05).
CONCLUSIONS
Antibiotic use in children <2 years of age is associated with lower vaccine-induced antibody levels to several vaccines.
背景
在疫苗诱导免疫发展的前 2 年，大多数儿童都被开了抗生素。研究人员提出，抗生素的使用与成人的疫苗诱导免疫呈负相关，但儿童的数据却缺乏。
方法
2006 年至 2016 年，对 6 至 24 个月大的儿童进行了队列研究。同时对病历中关于抗生素处方和疫苗抗体测量的回顾性、无计划的二次分析进行了回顾性、无计划的二次分析。对与白喉-破伤风-无细胞百日咳（DTaP）、灭活脊髓灰质炎（IPV）、流感嗜血杆菌 b 型（Hib）和肺炎球菌结合（PCV）疫苗相关的抗体测量进行了分析。
结果
共比较了 560 名儿童（342 名服用抗生素，218 名未服用抗生素）。接受抗生素治疗的儿童对几种 DTaP 和 PCV 抗原的抗体水平较低（P<0.05）。接受抗生素治疗的儿童在 9 个月和 12 个月时发生低于保护性水平的疫苗诱导抗体的频率更高（P<0.05）。随着时间的推移，抗生素疗程与疫苗诱导的抗体水平呈负相关。对于儿童每次接受的抗生素疗程，DTaP 抗原的预加强抗体水平降低 5.8%，Hib 降低 6.8%，IPV 降低 11.3%，PCV 降低 10.4%（均 P≤0.05），DTaP 抗原的后加强抗体水平降低 18.1%，Hib 降低 21.3%，IPV 降低 18.9%，PCV 降低 12.2%（均 P<0.05）。
结论
2 岁以下儿童使用抗生素与几种疫苗诱导的抗体水平较低有关。
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