Kertesz D A, Di Fabio J L, de Cunto Brandileone M C, Castañeda E, Echániz-Aviles G, Heitmann I, Homma A, Hortal M, Lovgren M, Ruvinsky R O, Talbot J A, Weekes J, Spika J S
Bureau of Infectious Diseases, Laboratory Centre for Disease Control, Health Canada, Ottawa, Canada.
Clin Infect Dis. 1998 Jun;26(6):1355-61. doi: 10.1086/516350.
Protein-polysaccharide conjugate vaccines against Streptococcus pneumoniae promise to be an effective public health intervention for children, especially in an era of increasing antimicrobial resistance. To characterize the distribution of capsular types in Latin America, surveillance for invasive pneumococcal infection in children < or = 5 years of age was done in six countries between February 1993 and April 1996. Fifty percent of 1,649 sterile-site isolates were from children with pneumonia, and 52% were isolated from blood. The 15 most common of the capsular types prevalent throughout the region accounted for 87.7% of all isolates. Overall, 24.9% of isolates had diminished susceptibility to penicillin: 16.7% had intermediate resistance and 8.3% had high-level resistance. Three customized vaccine formulas containing 7, 12, and 15 capsular types were found to have regional coverages of 72%, 85%, and 88%, respectively. This study emphasizes the need for local surveillance for invasive pneumococcal disease prior to the development and evaluation of protein-polysaccharide conjugate vaccines for children.
抗肺炎链球菌的蛋白质 - 多糖结合疫苗有望成为针对儿童的一种有效的公共卫生干预措施，尤其是在抗菌药物耐药性不断增加的时代。为了确定拉丁美洲荚膜型别分布情况，于1993年2月至1996年4月期间在六个国家对5岁及以下儿童侵袭性肺炎球菌感染进行了监测。1649株无菌部位分离株中，50%来自肺炎患儿，52%分离自血液。该地区普遍流行的15种最常见荚膜型别占所有分离株的87.7%。总体而言，24.9%的分离株对青霉素敏感性降低：16.7%有中度耐药，8.3%有高度耐药。发现含7种、12种和15种荚膜型别的三种定制疫苗配方的区域覆盖率分别为72%、85%和88%。本研究强调在开发和评估儿童蛋白质 - 多糖结合疫苗之前，需要对侵袭性肺炎球菌疾病进行本地监测。
