National Meningitis Reference Laboratory, Dept. of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece.
Department of Vaccine Preventable Diseases, National Public Health Organization (NPHO), Athens, Greece.
Vaccine. 2022 Aug 12;40(34):5079-5087. doi: 10.1016/j.vaccine.2022.07.015. Epub 2022 Jul 22.
As Greece is a country which has introduced the 13-valent pneumococcal conjugate vaccine (PCV13) both in the infant and in the adult immunization programs, the aim of the study was to investigate age-specific and serotype-specific trends of pneumococcal meningitis over an 11-year period (2010-2020).
Data are reported from pneumococcal meningitis cases [notified to the National Public Health Organization (NPHO)], with clinical samples and bacterial isolates sent for pneumococcal identification and serotyping at the National Meningitis Reference Laboratory (NMRL). Pneumococcal identification was performed directly on clinical samples or bacterial isolates by multiplex PCR (mPCR) assay, while serotyping was carried out by application of the Capsular Sequence Typing (CST) method with the combination of single tube PCR assays.
A total of 427 pneumococcal meningitis cases were notified to the NPHO between 2010 and 2020. Among those, 405 (94.8%) were microbiologically confirmed, while samples from 273 patients were sent to the NMRL for identification and/or further typing. The annual notification rate peaked at 0.47/100,000 in 2016 and since then has been decreasing. The incidence was highest in infants and in older adults. Pneumococcal serotypes were identified in 260/273 (95.2%) cases, where clinical samples were sent to the NMRL. The most prevalent serotypes (≥5%) were 3, 19A, 23B, 15B/C, 11A/D, 23A, 22F. During the study period there has been a decrease of PCV13 serotypes combined with an increase of non-PCV13 serotypes (p = 0.0045).
This is the first study to report serotypes for pneumococcal meningitis across all ages in the post-PCV13 era in Greece. There is a need to enhance surveillance, by close monitoring of the emerging serotypes and the impact of vaccination programs. Higher-valency PCVs may help to improve the coverage of pneumococcal disease.
由于希腊在婴儿和成人免疫计划中均引入了 13 价肺炎球菌结合疫苗（PCV13），因此本研究的目的是调查 11 年间（2010-2020 年）肺炎球菌性脑膜炎的特定年龄和血清型趋势。
报告的数据来自于向国家公共卫生组织（NPHO）报告的肺炎球菌性脑膜炎病例，临床样本和细菌分离株送往国家脑膜炎参考实验室（NMRL）进行肺炎球菌鉴定和血清分型。肺炎球菌鉴定直接在临床样本或细菌分离株上通过多重 PCR（mPCR）检测进行，而血清型则通过应用荚膜序列分型（CST）方法结合单管 PCR 检测进行。
2010 年至 2020 年期间，NPHO 共报告了 427 例肺炎球菌性脑膜炎病例。其中，405 例（94.8%）经微生物学证实，而 273 例患者的样本被送往 NMRL 进行鉴定和/或进一步分型。年报告率在 2016 年达到 0.47/100,000 的峰值，此后一直在下降。发病率在婴儿和老年人中最高。在向 NMRL 送检临床样本的 273 例病例中，鉴定出 260 例（95.2%）肺炎球菌血清型。最常见的血清型（≥5%）为 3、19A、23B、15B/C、11A/D、23A、22F。在研究期间，PCV13 血清型的数量减少，而非 PCV13 血清型的数量增加（p=0.0045）。
这是希腊 PCV13 时代后首次报告所有年龄段肺炎球菌性脑膜炎血清型的研究。需要通过密切监测新兴血清型和疫苗接种计划的影响，加强监测。更高价的 PCV 可能有助于提高肺炎球菌疾病的覆盖率。
