Dynamic changes in clinical characteristics and serotype distribution of invasive pneumococcal disease among adults in Japan after introduction of the pediatric 13-valent pneumococcal conjugate vaccine in 2013-2019．
Dynamic changes in clinical characteristics and serotype distribution of invasive pneumococcal disease among adults in Japan after introduction of the pediatric 13-valent pneumococcal conjugate vaccine in 2013-2019．
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2013-2019年引入儿童13价肺炎球菌结合疫苗后日本成人侵袭性肺炎球菌疾病临床特征和血清型分布的动态变化。
DOI：
10.1016/j.vaccine.2022.04.062
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发表时间：
2022
期刊：
影响因子：
5.5
通讯作者：
Oishi K.
中科院分区：
文献类型：
--
作者：
Tamura K;Chang B;Shimbashi R;Watanabe H;Tanabe Y;Kuronuma K;Oshima K;Maruyama T;Fujita J;Abe S;Kasahara K;Nishi J;Kubota T;Kinjo Y;Fujikura H;Fukusumi M;Shimada T;Sunagawa T;Suzuki M;Yamamoto Y;Oishi K.
为数不多的亚洲国家正在进行侵袭性肺炎球菌病(IPD)的全国性人群监测。我们的目的是评估日本成人IPD患者在2013年引入13价肺炎球菌结合疫苗(PCV13)后的临床特征和血清型分布。2013至2019年在成年人中进行了IPD监测，按时间段分析了1,995名患者(2013-2015年初；2016-2017年中；2018-2019年末)。我们发现，与2013-2015年期间相比，2018-2019年期间独立地与较低的致命结果风险相关。在儿童PCV13引入后的3年内，15-岁的患者和65岁-65岁的≥患者中，PCV13-非PCV7型患者的比例明显下降。相比之下，非疫苗血清型的比例在65岁的≥患者中显著增加，但在15岁-的人群中没有增加。在15岁至岁和65岁至65岁的≥成人中，23价多糖肺炎球菌疫苗(PPSV23-Non PCV13)的比例都没有明显变化。晚期65岁≥患者中PCV15型、PCV20型和PCV24型的比例分别为38%、56%和58%。我们的血清型分布数据支持儿童使用PCV13对成人的间接影响，并为估计在日本老年人中接种新开发的PCV对IPD的保护作用提供了基础。
Nationwide population-based surveillance for invasive pneumococcal disease (IPD) is being conducted in few Asian countries. We aimed to evaluate the clinical characteristics and serotype distribution among Japanese adult patients with IPD after introduction of the pediatric 13-valent pneumococcal conjugate vaccine (PCV13) in 2013. IPD surveillance was conducted among adults between 2013 and 2019, and 1,995 patients were analyzed by time period (early, 2013–2015; middle, 2016–2017; late, 2018–2019). We found that the period of 2018–2019 was independently associated with a lower risk of fatal outcome, compared with the period of 2013–2015. The proportion of those with serotype PCV13-nonPCV7 decreased significantly in patients aged 15–64 years and in those aged ≥ 65 years within 3 years after the introduction of pediatric PCV13. By contrast, the proportion of those with nonvaccine serotype increased significantly in those aged ≥ 65 years, but not in those aged 15–64 years. No significant change was found in the proportion of 23-valent polysaccharide pneumococcal vaccine (PPSV23)-nonPCV13 in both of adults aged 15–64 years and ≥ 65 years. The proportions of PCV15-, PCV20- and PCV24-covered serotypes were 38%, 56% and 58% in adult patients with IPD aged ≥ 65 years during the late period. Our data on the serotype distribution support an indirect effect from pediatric PCV13 use among adults, and afford a basis for estimates of protection against IPD by vaccination with newly developed PCVs in older adults in Japan.