Carriage of Streptoccoccus pneumoniae 7 years after implementation of vaccination program in a population with very high and long-lasting coverage, Italy
Carriage of Streptoccoccus pneumoniae 7 years after implementation of vaccination program in a population with very high and long-lasting coverage, Italy
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DOI：
10.1016/j.vaccine.2012.01.067
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发表时间：
2012-03-16
期刊：
影响因子：
5.5
通讯作者：
Icardi, Giancarlo
中科院分区：
文献类型：
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作者：
Ansaldi, Filippo;de Florentiis, Daniela;Icardi, Giancarlo
为了评估7价肺炎球菌疫苗（PCV7）计划和超过4年的极高疫苗接种覆盖率如何影响儿科人群中肺炎链球菌血清型的流行率，并评估后疫苗时代携带肺炎链球菌的人口、行为和危险因素，进行了一项鼻咽携带的横断面研究。通过整群抽样的方式纳入了代表开放人群的 669 名 5 岁以下儿童。使用高灵敏度技术检测多血清型携带，即肉汤富集和实时PCR以及分别用于检测和分型的序贯PCR。在 669 名登记儿童中，97.8% 遵守推荐的 PCV7 疫苗接种计划。将利古里亚人群作为标准人群，对年龄进行分层后调整。年龄加权携带率为50.1%，78%的携带者被超过一种血清型定植。随着年龄的增长，携带率增加，从第一年的 22% 增加到第二年的 48.6%，再到 25-59 个月龄组的 60%。 PCV7、PCV10 或 PCV13 血清型的年龄加权患病率分别为 10.3%、20.3% 和 27.5%。 PCV7 血清型主要以血清型 4 为代表，该血清型从出生后 3 岁开始携带，导致成人侵袭性肺炎球菌病 (IPD) 和非 IPD，但不会导致儿童患侵袭性肺炎球菌病 (IPD)，这证实了疫苗的高有效性。在最近推出的疫苗中包含的血清型中，血清型 5 和 19A 的患病率较高，分别占人口的 15.2% 和 8.8%。多变量分析显示，年龄、家中兄弟姐妹的存在以及日托出勤协变量与肺炎链球菌携带密切相关。总而言之，超过 7 年的 PCV7 疫苗接种以及过去 4 年的极高覆盖率导致了肺炎链球菌携带率较低。出生后第一年的感染率在接下来的几年中迅速增加，并且非 PCV7 血清型携带率很高。 (C) 2012 Elsevier Ltd. 保留所有权利。
To evaluate how the 7-valent pneumococcal vaccine (PCV7) programme and the very high vaccination coverage reached for over 4 years affected the prevalence of Streptoccoccus pneumoniae serotypes in the paediatric population and to evaluate demographic, behavioural and risk factors for carriage in the post-vaccination era, a cross-sectional study on nasopharyngeal carriage was performed. Six hundred sixty-nine children under the age of 5, representative of the open population, were enrolled by cluster sampling. High sensitive techniques for detection of multi-serotype carriage, i.e. broth enrichment and real-time PCR and sequential PCRs for detection and typing, respectively, were used. Of the 669 enrolled children, 97.8% were compliant with the recommended PCV7 vaccination schedule. Post-stratification adjustment for age was applied considering the Ligurian population as standard population.Age-weighted carriage rate was 50.1% and 78% of carriers were colonized by more than one serotype. The prevalence of carriage increased with age from 22% in the first year of life, to 48.6% in the second year of life and to 60% in the 25-59 month age group. Age-weighted prevalence of any of the PCV7, PCV10 or PCV13 serotypes was 10.3%, 20.3% and 27.5%, respectively. PCV7 serotypes were mainly represented by serotype 4 that was carried since the 3rd year of life and was responsible for invasive pneumococcal disease (IPD) and non-IPD in adults, but not in children confirming the high vaccine effectiveness. Among the serotypes included in recently available vaccines, serotypes 5 and 19A showed a higher prevalence, being carried by 15.2% and 8.8% of the population, respectively.A multivariate analysis showed that age, the presence of child siblings at home and day care attendance covariates were strongly associated with S. pneumoniae carriage.In conclusion, over 7 years of vaccination with PCV7 and very high coverage in the last 4 years has led to low carriage prevalence in the first year of life rapidly increasing in the following years and high prevalence of non-PCV7 serotypes carriage. (C) 2012 Elsevier Ltd. All rights reserved.