Effectiveness of a serogroup B outer membrane vesicle meningococcal vaccine against gonorrhoea: a retrospective observational study.
Effectiveness of a serogroup B outer membrane vesicle meningococcal vaccine against gonorrhoea: a retrospective observational study.
复制标题
血清群B外膜囊泡脑膜炎球菌疫苗对淋病的有效性：一项回顾性观察研究
DOI：
10.1016/s1473-3099(21)00812-4
复制
发表时间：
2022-07
影响因子：
56.3
通讯作者：
Kirkcaldy, Robert D.
中科院分区：
文献类型：
--
作者：
Abara, Winston E.;Bernstein, Kyle T.;Lewis, Felicia M. T.;Schillinger, Julia A.;Feemster, Kristen;Pathela, Preeti;Hariri, Susan;Islam, Aras;Eberhart, Michael;Cheng, Iris;Ternier, Alexandra;Slutsker, Jennifer Sanderson;Mbaeyi, Sarah;Madera, Robbie;Kirkcaldy, Robert D.
对当前淋病的抗菌药敏感性下降，抗生素治疗和治疗选择不足，增加了无法治愈的淋病的可能性。需要新的预防方法，如接种疫苗。外膜囊泡B群脑膜炎双球菌疫苗可能对淋病有保护作用。我们评估了一种B群脑膜炎双球菌外膜泡囊疫苗(MenB-4C)在美国两个城市16-23岁人群中预防淋病的有效性。我们从2016年至2018年纽约市和费城的性传播感染监测记录中确定了16-23岁人群中实验室确认的淋病和衣原体感染。我们将淋病和衣原体病例记录与免疫登记记录联系起来，以确定感染时的MenB-4C疫苗接种状态，定义为完全接种(两剂MenB-4C疫苗相隔30-180天)、部分接种(单剂MenB-4C疫苗)或不接种(B组脑膜炎双球菌疫苗未接种)。使用对数二项回归和广义估计方程来说明每个患者的多重感染之间的相关性，我们计算了调整后的患病率(APR)和95%的顺位指数，以确定接种疫苗是否对淋病具有保护作用。我们使用个人水平的数据进行描述性分析，使用感染水平的数据进行回归分析。在2016年1月1日至2018年12月31日期间，我们在与免疫接种登记有关的109 737人中发现167 706例感染(18 099例淋球菌感染，124 876例衣原体感染，24 731例淋球菌和衣原体混合感染)。接种者7692人，接种1针以上者4032人(52.4%)，接种2针以上者3596人(46.7%)，接种3针以上者(1.0%)。与未接种相比，完全接种系列(APR 0·60，95%CI 0·47-0·77；p<；0·0001)和部分接种系列(0·74，0·63-0·88；p=0·0012)对淋病有保护作用。完整的MenB-4C疫苗系列对淋病的有效率为40%(95%CI 23-53)，部分MenB-4C疫苗系列的有效率为26%(12-37)。接种MenB-4C疫苗与淋病患病率降低有关。MenB-4C对淋病奈瑟菌具有交叉保护作用。开发一种有效的淋球菌疫苗可能是可行的，这对淋病的预防和控制具有重要意义。没有。
Declining antimicrobial susceptibility to current gonorrhoea antibiotic treatment and inadequate treatment options have raised the possibility of untreatable gonorrhoea. New prevention approaches, such as vaccination, are needed. Outer membrane vesicle meningococcal serogroup B vaccines might be protective against gonorrhoea. We evaluated the effectiveness of a serogroup B meningococcal outer membrane vesicle vaccine (MenB-4C) against gonorrhoea in individuals aged 16–23 years in two US cities. We identified laboratory-confirmed gonorrhoea and chlamydia infections among individuals aged 16–23 years from sexually transmitted infection surveillance records in New York City and Philadelphia from 2016 to 2018. We linked gonorrhoea and chlamydia case records to immunisation registry records to determine MenB-4C vaccination status at infection, defined as complete vaccination (two MenB-4C doses administered 30–180 days apart), partial vaccination (single MenB-4C vaccine dose), or no vaccination (serogroup B meningococcal vaccine naive). Using log-binomial regression with generalised estimating equations to account for correlations between multiple infections per patient, we calculated adjusted prevalence ratios (APR) and 95% CIs to determine if vaccination was protective against gonorrhoea. We used individual-level data for descriptive analyses and infection-level data for regression analyses. Between Jan 1, 2016, and Dec 31, 2018, we identified 167 706 infections (18 099 gonococcal infections, 124 876 chlamydial infections, and 24 731 gonococcal and chlamydial co-infections) among 109 737 individuals linked to the immunisation registries. 7692 individuals were vaccinated, of whom 4032 (52·4%) had received one dose, 3596 (46·7%) two doses, and 64 (<1·0%) at least three doses. Compared with no vaccination, complete vaccination series (APR 0·60, 95% CI 0·47–0·77; p<0·0001) and partial vaccination series (0·74, 0·63–0·88; p=0·0012) were protective against gonorrhoea. Complete MenB-4C vaccination series was 40% (95% CI 23–53) effective against gonorrhoea and partial MenB-4C vaccination series was 26% (12–37) effective. MenB-4C vaccination was associated with a reduced gonorrhoea prevalence. MenB-4C could offer cross-protection against Neisseria gonorrhoeae. Development of an effective gonococcal vaccine might be feasible with implications for gonorrhoea prevention and control. None.