Suppr
超能文献

13价肺炎球菌结合疫苗的引入对蒙古国乌兰巴托住院儿童中与呼吸道合胞病毒或流感病毒相关的严重下呼吸道感染的影响。

Impact of pneumococcal conjugate vaccine 13 introduction on severe lower respiratory tract infections associated with respiratory syncytial virus or influenza virus in hospitalized children in Ulaanbaatar, Mongolia.

作者信息

Do Lien Anh Ha, Tsedenbal Naranzul, Khishigmunkh Chimidregzen, Tserendulam Bazarkhuu, Altanbumba Lkhagvadorj, Luvsantseren Dashtseren, Ulziibayar Munkhchuluun, Suuri Bujinlkham, Narangerel Dorj, Tsolmon Bilegtsaikhan, Demberelsuren Sodbayar, Nguyen Cattram, Mungun Tuya, von Mollendorf Claire, Badarch Darmaa, Mulholland Kim

机构信息

New Vaccines Group, Murdoch Children's Research Institute, Melbourne, Australia.

Department of Paediatrics, The University of Melbourne, Melbourne, Australia.

出版信息

IJID Reg. 2024 Mar 19;11:100357. doi: 10.1016/j.ijregi.2024.100357. eCollection 2024 Jun.

DOI:10.1016/j.ijregi.2024.100357

PMID:38577554

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10992709/

Abstract

OBJECTIVES

Limited data indicate a beneficial effect of pneumococcal conjugate vaccines (PCVs) on respiratory syncytial virus (RSV) and influenza infections in young children. We evaluated the impact of 13-valent PCV (PCV13) introduction on the incidence of severe lower respiratory tract infections (LRTIs) associated with RSV or influenza in hospitalized children.

METHODS

Our study was restricted to children aged <2 years with arterial oxygen saturation <93% and children with radiologically confirmed pneumonia nested in a pneumonia surveillance project in four districts of Ulaanbaatar city, Mongolia. We tested nasopharyngeal swabs collected on admission for RSV and influenza using quantitative reverse transcription-polymerase chain reaction. The impact of PCV13 on the incidence of LRTI outcomes associated with RSV or with influenza for the period April 2015-March 2020 was estimated. Incidence rate ratios comparing pre- and post-vaccine periods were estimated for each outcome for each district using negative binomial models and for all districts combined with a mixed-effects negative binomial model. Adjusted models accounted for seasonality. Sensitivity analyses were conducted to assess the robustness of our findings.

RESULTS

Among 5577 tested cases, the adjusted incidence rate ratios showed a trend toward a reduction in RSV-associated outcomes: all LRTIs (0.77, 95% confidence interval [CI] 0.44-1.36), severe LRTIs (0.88, 95% CI 0.48-1.62), very severe LRTIs (0.76, 95% CI 0.42-1.38), and radiologically confirmed pneumonia (0.66, 95% CI 0.32-1.38) but inconsistent trends in outcomes associated with influenza.

CONCLUSIONS

No significant reductions were observed in any outcomes associated with RSV and influenza after PCV introduction.

摘要

目的

有限的数据表明肺炎球菌结合疫苗（PCV）对幼儿呼吸道合胞病毒（RSV）和流感感染有有益作用。我们评估了引入13价肺炎球菌结合疫苗（PCV13）对住院儿童中与RSV或流感相关的严重下呼吸道感染（LRTI）发病率的影响。

方法

我们的研究仅限于动脉血氧饱和度<93%的2岁以下儿童以及蒙古国乌兰巴托市四个区的肺炎监测项目中经放射学确诊的肺炎患儿。我们使用定量逆转录-聚合酶链反应检测入院时采集的鼻咽拭子中的RSV和流感病毒。估计了2015年4月至2020年3月期间PCV13对与RSV或流感相关的LRTI结局发病率的影响。使用负二项模型估计每个区每种结局在疫苗接种前后时期的发病率比，并使用混合效应负二项模型估计所有区合并后的发病率比。校正模型考虑了季节性。进行敏感性分析以评估我们研究结果的稳健性。

结果

在5577例检测病例中，校正后的发病率比显示出与RSV相关结局有降低趋势：所有LRTI（0.77，95%置信区间[CI]0.44-1.36）、严重LRTI（0.88，95%CI0.48-1.62）、极严重LRTI（0.76，95%CI0.42-1.38）以及放射学确诊的肺炎（0.66，95%CI0.32-1.38），但与流感相关的结局趋势不一致。