Initial Effects of the National PCV7 Childhood Immunization Program on Adult Invasive Pneumococcal Disease in Israel
Initial Effects of the National PCV7 Childhood Immunization Program on Adult Invasive Pneumococcal Disease in Israel
复制标题
以色列国家 PCV7 儿童免疫计划对成人侵袭性肺炎球菌病的初步效果
作者：
G. Regev;G. Rahav;K. Riesenberg;Y. Wiener‐Well;J. Strahilevitz;M. Stein;D. Glikman;Gabriel Weber;I. Potasman;R. Dagan
背景PCV 7于2009年7月在以色列被引入作为普遍的儿童疫苗接种，PCV 13于2010年11月被引入。在此，我们报告了PCV 7实施后两年和PCV 13预期效果之前的成人侵袭性肺炎球菌病（IPD）数据。方法一个正在进行的全国性主动监测（所有27个实验室进行血培养在以色列），提供所有的血液和CSF S。2009年7月开始从18岁以上人群中分离肺炎分离株。捕获-再捕获方法确保了>95%的病例报告。所有分离株均在一个中心实验室进行血清分型。记录了90%的IPD结局和病史。PCV实施后第二年与第一年进行比较。结果2009年7月至2011年6月，共报告IPD病例970例，连续两年年发病率分别为9.17和10.16/10万。病死率分别为20%和19.1%。IPD和CFR的发生率随年龄和合并症数量的增加而增加。第二个冬季的发病率显著更高，7.79/100，000与第一个冬季的6.14/100，000，p = 0.004，夏季月份的发病率无显著下降（3.02至2.48/100，000）。 由PCV 7血清型引起的IPD病例比例从27.5%降至13.1%（第1年至第2年）（p<0.001）。然而，非PCV 13菌株从32.7%增加到40.2%（p = 0.017）。 非PCV 13菌株的增加在免疫功能低下的患者中非常显著，在非免疫功能低下的风险患者或老年患者（>64岁）中程度较低。在年轻/健康患者中，血清型5是主要增加的血清型。青霉素和头孢曲松耐药性在第二年显著下降。结论虽然IPD的总体年发病率没有变化，但PCV 7疫苗接种的间接影响是显而易见的，所有年龄组的PCV 7血清型显著减少。非VT 13菌株的增加在免疫功能低下的患者中是显著的。需要更长时间的随访，以了解婴儿接种疫苗对每年IPD的全面影响。
Background PCV7 was introduced as universal childhood vaccination in Israel in July 2009 and PCV13 in November 2010. Here we report data on adult invasive pneumococcal disease (IPD), two years post PCV7 implementation and before an expected effect of PCV13. Methods An ongoing nationwide active-surveillance (all 27 laboratories performing blood cultures in Israel), providing all blood & CSF S. pneumoniae isolates from persons >18 y was initiated in July 2009. Capture-recapture method assured reporting of >95% cases. All isolates were serotyped in one central laboratory. IPD outcome and medical history were recorded in 90%. Second year post PCV implementation is compared to the first year. Results During July 2009 to June 2011, 970 IPD cases were reported (annual incidence [/100,000] of 9.17 and 10.16 in the two consecutive years, respectively). Respective case fatality rates (CFRs) were 20% and 19.1%. Incidence of IPD and CFR increased with age and number of comorbidities. Incidence rate was significantly greater during the second winter, 7.79/100,000 vs. 6.14/100,000 in first winter, p = 0.004, with a non-significant decrease during summer months (3.02 to 2.48/100,000). The proportion of IPD cases due to PCV7-serotypes decreased from 27.5% to 13.1% (first to second year) (p<0.001). Yet, non-PCV13-strains increased from 32.7% to 40.2% (p = 0.017). The increase in non-PCV13-strains was highly significant in immunocompromised patients and to a lesser degree in non-immunocompromised at risk or in older patients (>64 y). Among younger/healthier patients serotype 5 was the major increasing serotype. Penicillin and ceftriaxone resistance decreased significantly in the second year. Conclusions While overall annual incidence of IPD did not change, the indirect effect of PCV7 vaccination was evident by the significant decrease in PCV7 serotypes across all age groups. Increase in non-VT13 strains was significant in immunocompromised patients. A longer follow-up is required to appreciate the full effect of infant vaccination on annual IPD.
PCV7 时代末期犹他州成人中的肺炎链球菌血清型。
影响因子：
5.5
作者：
Kendall,BrianA;Dascomb,KristinK;Mehta,RajeshR;Mason,EdwardO;Ampofo,Krow;Pombo,DavidJ;Pavia,AndrewT;Byington,CarrieL
通讯作者：
Byington,CarrieL