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越南南部儿童细菌性脑膜炎监测:2012年至2021年的趋势及疫苗接种影响

Childhood Bacterial Meningitis Surveillance in Southern Vietnam: Trends and Vaccination Implications From 2012 to 2021.

作者信息

Truong Hieu Cong, Van Phan Thanh, Nguyen Hung Thanh, Truong Khanh Huu, Do Viet Chau, Pham Nguyet Nguyen My, Ho Thang Vinh, Phan Tram Thi Quynh, Hoang Thang Anh, Soetewey Antoine, Ho Thuy Nguyen Loc, Pham Quang Duy, Luong Quang Chan, Vo Dai Thi Trang, Nguyen Thuong Vu, Speybroeck Niko

机构信息

Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam.

Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium.

出版信息

Open Forum Infect Dis. 2023 May 2;10(7):ofad229. doi: 10.1093/ofid/ofad229. eCollection 2023 Jul.

Abstract

BACKGROUND

This retrospective hospital-based surveillance aimed to assess the epidemiology, causative pathogens trend, and serotypes distribution of pneumococcal meningitis among children aged under 5 years with bacterial meningitis in Southern Vietnam after the introduction of pentavalent vaccine in the Expanded Program on Immunization (EPI).

METHODS

From 2012 to 2021, cerebrospinal fluid samples were collected from children aged under 5 years with suspected bacterial meningitis at Children's Hospitals 1 and 2 in Ho Chi Minh City. Probable bacterial meningitis (PBM) cases were identified using biochemistry and cytology. Real-time polymerase chain reaction was used to confirm cases of confirmed bacterial meningitis (CBM) caused by , , or . serotyping was performed.

RESULTS

Of the 2560 PBM cases, 158 (6.2%) were laboratory-confirmed. The CBM proportion decreased during the 10-year study and was associated with age, seasonality, and permanent residence. was the most common pathogen causing bacterial meningitis (86.1%), followed by (7.6%) and (6.3%). The case-fatality rate was 8.2% (95% confidence interval, 4.2%-12.2%). Pneumococcal serotypes 6A/B, 19F, 14, and 23F were the most prevalent, and the proportion of pneumococcal meningitis cases caused by the 10-valent pneumococcal conjugate vaccine (PCV) serotypes decreased from 96.2% to 57.1% during the PCV eras.

CONCLUSIONS

is the most frequent causative agent of bacterial meningitis in children aged under 5 years in Southern Vietnam over the last decade. Policymakers may need to consider introducing PCVs into the EPI to effectively prevent and control bacterial meningitis.

摘要

背景

这项基于医院的回顾性监测旨在评估在扩大免疫规划(EPI)中引入五价疫苗后,越南南部5岁以下细菌性脑膜炎儿童中肺炎球菌性脑膜炎的流行病学、致病病原体趋势和血清型分布。

方法

2012年至2021年期间,从胡志明市第一和第二儿童医院收集了5岁以下疑似细菌性脑膜炎儿童的脑脊液样本。使用生物化学和细胞学方法确定可能的细菌性脑膜炎(PBM)病例。采用实时聚合酶链反应确认由、或引起的确诊细菌性脑膜炎(CBM)病例。进行血清分型。

结果

在2560例PBM病例中,158例(6.2%)经实验室确诊。在10年的研究期间,CBM比例下降,且与年龄、季节性和常住地有关。是引起细菌性脑膜炎最常见的病原体(86.1%),其次是(7.6%)和(6.3%)。病死率为8.2%(95%置信区间,4.2%-12.2%)。肺炎球菌血清型6A/B、19F、14和23F最为常见,在肺炎球菌结合疫苗(PCV)时代,由10价PCV血清型引起的肺炎球菌性脑膜炎病例比例从96.2%降至57.1%。

结论

在过去十年中,是越南南部5岁以下儿童细菌性脑膜炎最常见的病原体。政策制定者可能需要考虑将PCV引入EPI,以有效预防和控制细菌性脑膜炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c205/10316691/4b1c9095e39d/ofad229_ga1.jpg

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