Pneumococcal vaccine impact on otitis media microbiology: A New Zealand cohort study before and after the introduction of PHiD-CV10 vaccine
Pneumococcal vaccine impact on otitis media microbiology: A New Zealand cohort study before and after the introduction of PHiD-CV10 vaccine
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DOI：
10.1016/j.vaccine.2016.05.041
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发表时间：
2016-07-19
期刊：
影响因子：
5.5
通讯作者：
Mills, Nikki
中科院分区：
文献类型：
--
作者：
Best, Emma J.;Walls, Tony;Mills, Nikki
我们比较了两组置入通气管(VT)的儿童中耳液(MEF)的微生物学。第一组是七价肺炎链球菌结合疫苗(PCV7)时代的儿童，第二组是引入十价肺炎球菌疫苗(PHID-CV10)的儿童。方法：在2011年(第一阶段)和2014年(第二阶段)，分别采集325名儿童和319名儿童在插入VT时的MEF和NP样本。匹配的对照组收集了137名儿童(阶段1)和154名儿童(阶段2)的NP拭子。对所有NP和MEF样本进行培养，进一步进行嗜血杆菌的分子鉴定，肺炎链球菌的血清学分型，并对所有MEF样本进行聚合酶链式反应(PCR)检测。结果：在第二阶段，>；=3剂PHiD-CV10的免疫覆盖率为93%。在MEF和NP中，3种主要耳部病原体的培养和分子检测的比率和比例在MEF和NP的第一阶段和第二阶段之间都没有变化。每季度培养一次流感嗜血杆菌，在这两个时间段的MEF样本中，有53%的样本进行了PCR检测。肺炎链球菌和卡他莫拉氏菌的培养比例高达13%，并分别在27%和40%的MEF样本中进行了PCR检测。在接受VT手术的儿童中，从NP样本中分离到的最常见的细菌是流感嗜血杆菌(61%)，而在非中耳炎易发组中，卡他毛杆菌(49%)是最常见的。19A是MEF和NP2期标本中最突出的肺炎链球菌血清型。在嗜血杆菌分离株中，95%在这两个时期都被确认为非分型流感嗜血杆菌(NTHi)。结论：新西兰实施PHiD-CV10后，在既往耳部疾病的儿童中，NP和MEF中的三种主要耳病原体没有显著变化。对于这些儿童，非分型流感嗜血杆菌仍然是检测到的主要耳部病原体。(C)2016年提交人。爱思唯尔有限公司出版。
We compared the microbiology of middle ear fluid (MEF) in two cohorts of children having ventilation tube (VT) insertion; the first in the era of 7-valent Streptococcus pneumoniae conjugate vaccine (PCV7) and the second following introduction of the ten-valent pneumococcal vaccine (PHiD-CV10).Methods: During 2011 (Phase 1) and again in 2014 (Phase 2) MEF and NP samples from 325 children and 319 children were taken at the time of VT insertion. A matched comparison group had NP swabs collected with 137 children (Phase 1) and 154 (Phase 2). Culture was performed on all NP and MEF samples with further molecular identification of Haemophilus species, serotyping of S. pneumoniae, and polymerase chain reaction (PCR) testing on all MEF samples.Results: In Phase 2 immunisation coverage with >= 3 doses of PHiD-CV10 was 93%. The rate and ratios of culture and molecular detection of the 3 main otopathogens was unchanged between Phase 1 and Phase 2 in both MEF and NP. Haemophilus influenzae was cultured in one quarter and detected by PCR in 53% of MEF samples in both time periods. S. pneumoniae and Moraxella catarrhalis were cultured in up to 13% and detected by PCR in 27% and 40% respectively of MEF samples. H. influenzae was the most common organism isolated from NP samples (61%) in the children undergoing VT surgery whilst M. catarrhalis (49%) was the most common in the non-otitis prone group. 19A was the most prominent S. pneumoniae serotype in both MEF and NP samples in Phase 2. Of Haemophilus isolates, 95% were confirmed to be non-typeable H. influenzae (NTHi) over both time periods.Conclusion: Following implementation of PHiD-CV10 in New Zealand, there has been no significant change in the 3 major otopathogens in NP or MEF in children with established ear disease. For these children non-typeable H. influenzae remains the dominant otopathogen detected. (C) 2016 The Authors. Published by Elsevier Ltd.