Miliya Thyl, Soputhy Chansovannara, Leab Phana, Tan Pisey, Sao Sena, Heffelfinger James D, Batmunkh Nyambat, Ork Vichit, Hossain Md Shafiqul, Day Nicholas P J, Turner Claudia, Turner Paul
Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia.
Regional Office for the Western Pacific, World Health Organization, Manila, Philippines.
IJID Reg. 2023 May 21;8:9-15. doi: 10.1016/j.ijregi.2023.05.005. eCollection 2023 Sep.
This study sought to characterize pneumococcal colonization and clinical/radiological features in Cambodian children admitted to hospital with an illness compatible with pneumonia following national introduction of the 13-valent pneumococcal conjugate vaccine (PCV13).
Children aged 0-59 months admitted to Angkor Hospital for Children who met the World Health Organization (WHO) case definition for clinical pneumonia were enrolled over a 3-year period. Clinical, radiological and vaccination data were collected at enrolment. A nasopharyngeal swab was collected for detection of pneumococcal colonization using the WHO standard culture method.
Between 1 September 2015 and 31August 2018, 2209 analysable illness episodes were enrolled. Pneumococci were detected in 943/2209 (42.7%) children. PCV13 serotypes were detected less frequently in children who had been vaccinated appropriately for their age compared with undervaccinated children: 309/567 (53.6%) vs 216/342 (63.2%) (=0.006). Age-appropriate PCV13 vaccination was negatively associated with hypoxic presentation [adjusted odds ratio (aOR) 0.72, 95% confidence interval (CI) 0.60-0.87; =0.0006] and primary endpoint pneumonia on chest x ray (aOR 0.69, 95% CI 0.54-0.90; =0.006).
The introduction of PCV13 in Cambodia was associated with a decline in vaccine serotype nasopharyngeal colonization, and clinical and radiological severity in children hospitalized with clinical pneumonia.
本研究旨在描述在柬埔寨全国引入13价肺炎球菌结合疫苗（PCV13）后，因患与肺炎相符疾病而住院的儿童的肺炎球菌定植情况以及临床/放射学特征。
在三年期间，招募了吴哥儿童医院收治的符合世界卫生组织（WHO）临床肺炎病例定义的0至59个月儿童。在入组时收集临床、放射学和疫苗接种数据。采集鼻咽拭子，采用WHO标准培养方法检测肺炎球菌定植情况。
在2015年9月1日至2018年8月31日期间，共纳入2209例可分析的疾病发作病例。943/2209（42.7%）名儿童检测到肺炎球菌。与未充分接种疫苗的儿童相比，年龄适宜接种PCV13疫苗的儿童中检测到PCV13血清型的频率较低：309/567（53.6%）对216/342（63.2%）（P=0.006）。年龄适宜的PCV13疫苗接种与低氧表现呈负相关[调整优势比（aOR）0.72，95%置信区间（CI）0.60-0.87；P=0.0006]，与胸部X线检查显示的主要终点肺炎呈负相关（aOR 0.69，95%CI ）。
在柬埔寨引入PCV13与疫苗血清型鼻咽定植减少以及临床肺炎住院儿童的临床和放射学严重程度降低有关。
