肺炎球菌血清型分布以及现有和在研肺炎球菌疫苗的覆盖情况。

Pneumococcal serotype distribution and coverage of existing and pipeline pneumococcal vaccines.

作者信息

King Laura M, Andrejko Kristin L, Kobayashi Miwako, Xing Wei, Cohen Adam L, Self Wesley H, Resser J Jackson, Whitney Cynthia G, Baughman Adrienne, Kio Mai, Grijalva Carlos G, Traenkner Jessica, Rouphael Nadine, Lewnard Joseph A

机构信息

School of Public Health, University of California, Berkeley, Berkeley, California, United States.

Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States.

出版信息

J Infect Dis. 2025 Jul 22. doi: 10.1093/infdis/jiaf376.

DOI:10.1093/infdis/jiaf376

PMID:40692487

Abstract

BACKGROUND

Next-generation pneumococcal conjugate vaccines (PCVs) target an expanding array of serotype antigens. We assessed the proportions of invasive pneumococcal disease (IPD) and pneumococcal acute respiratory infections (ARIs) caused by serotypes targeted by existing and pipeline PCVs, and annual U.S. pneumococcal disease burdens potentially preventable by these products.

METHODS

We estimated serotype distribution and proportions of pneumococcal ARIs (acute otitis media [AOM; children only], sinusitis, non-bacteremic pneumonia) and IPD attributable to serotypes targeted by each PCV using Markov chain Monte Carlo approaches incorporating data from epidemiological studies and Active Bacterial Core Surveillance. We then estimated annual numbers of outpatient-managed ARIs, non-bacteremic pneumonia hospitalizations, and IPD cases potentially preventable by PCVs by multiplying disease incidence rates by PCV-targeted disease proportions and vaccine effectiveness estimates.

RESULTS

In children, PCV15, PCV20, PCV24, PCV25, and PCV31 serotypes account for 16% (95% confidence interval: 15-17%), 31% (30-32%), 34% (32-35%), 43% (42-44%), and 68% (67-69%) of pneumococcal AOM, respectively. In adults, PCV15, PCV20, PCV21, PCV24, PCV25, and PCV31 serotypes account for 43% (38-47%), 52% (47-57%), 69% (64-73%), 65% (61-70%), 62% (57-67%), and 87% (83-90%) of pneumococcal non-bacteremic pneumonia. For IPD, 42-85% of pediatric and 42-94% of adult cases were due to PCV-targeted serotypes. PCV-preventable burdens encompassed 270,000-3,300,000 outpatient-managed ARIs, 2,000-17,000 pneumonia hospitalizations, and 3,000-14,000 IPD cases annually.

CONCLUSIONS

Across pneumococcal conditions, coverage and preventable burdens were lowest for PCV15 and highest for PCV31, with PCV21 also targeting sizeable burdens of adult disease. Comparative estimates of preventable disease burden may inform future policy.

摘要

背景

新一代肺炎球菌结合疫苗（PCV）针对的血清型抗原范围不断扩大。我们评估了现有和在研PCV所针对血清型引起的侵袭性肺炎球菌疾病（IPD）和肺炎球菌急性呼吸道感染（ARI）的比例，以及这些产品在美国每年可能预防的肺炎球菌疾病负担。

方法

我们使用马尔可夫链蒙特卡罗方法，结合流行病学研究和主动细菌核心监测数据，估计了每种PCV所针对血清型导致的肺炎球菌ARI（急性中耳炎[AOM；仅儿童]、鼻窦炎、非菌血症性肺炎）和IPD的血清型分布及比例。然后，我们通过将疾病发病率乘以PCV针对疾病的比例和疫苗效力估计值，估计了每年门诊管理的ARI、非菌血症性肺炎住院病例和IPD病例中可能可被PCV预防的数量。

结果

在儿童中，PCV15、PCV20、PCV24、PCV25和PCV31血清型分别占肺炎球菌AOM的16%（95%置信区间：15 - 17%）、31%（30 - 32%）、34%（32 - 35%）、43%（42 - 44%）和68%（67 - 69%）。在成人中，PCV15、PCV20、PCV21、PCV24、PCV25和PCV31血清型分别占肺炎球菌非菌血症性肺炎的43%（38 - 47%）、52%（47 - 57%）、69%（64 - 73%）、65%（61 - 70%）、62%（57 - 67%）和87%（83 - 90%）。对于IPD，42% - 85%的儿科病例和42% - 94%的成人病例是由PCV针对的血清型引起的。PCV可预防的负担包括每年270,000 - 3,300,000例门诊管理的ARI、2,000 - 17,000例肺炎住院病例和3,000 - 14,000例IPD病例。