Laurichesse H, Grimaud O, Waight P, Johnson A P, George R C, Miller E
Service des Maladies Infectieuses, Hôtel-Dieu, CHU de Clemont Ferrand, France.
Commun Dis Public Health. 1998 Mar;1(1):22-7.
A total of 10,346 blood and 682 cerebrospinal fluid (CSF) isolates of Streptococcus pneumoniae were reported to the PHLS Communicable Disease Surveillance Centre from laboratories in England and Wales from 1 January 1993 to 31 December 1995. This corresponds to a mean annual incidence of 6.7 per 100,000 episodes of bacteraemia and 0.44/100,000 of meningitis. Absolute numbers of pneumococcal bacteraemia were similar to levels reported between 1990 and 1992, but fewer isolates of pneumococci were made from CSF. There was no discernible overall trend between 1993 and 1995, but age specific incidence suggested a slight increase in bacteraemia in older age groups. Estimated case fatality rates were 20% for pneumococcal bacteraemia and 22% for meningitis. The proportion of pneumococcal strains resistant to penicillin and erythromycin rose between 1989 and 1995 from 0.3% to 2.9% and 3.3% to 10.9%, respectively. The persistent threat of invasive pneumococcal infections highlights the need for continuing laboratory surveillance (including serotyping), appropriate use of antibiotics, and immunisation of groups at risk. The development of conjugate vaccines offers new prospects for prevention.
1993年1月1日至1995年12月31日期间，英格兰和威尔士各实验室向公共卫生实验室服务处传染病监测中心报告了总共10346株血液和682株脑脊液分离的肺炎链球菌。这相当于菌血症的年平均发病率为每10万例中有6.7例，脑膜炎的年平均发病率为每10万例中有0.44例。肺炎球菌菌血症的绝对数量与1990年至1992年期间报告的水平相似，但从脑脊液中分离出的肺炎球菌菌株较少。1993年至1995年期间没有明显的总体趋势，但按年龄组划分的发病率表明老年人群菌血症略有增加。肺炎球菌菌血症的估计病死率为20%，脑膜炎为22%。1989年至1995年期间，对青霉素和红霉素耐药的肺炎球菌菌株比例分别从0.3%升至2.9%和从3.3%升至10.9%。侵袭性肺炎球菌感染的持续威胁凸显了持续进行实验室监测（包括血清分型）、合理使用抗生素以及对高危人群进行免疫接种的必要性。结合疫苗的研发为预防工作带来了新的前景。
