Invasive pneumococcal disease and the potential for prevention by vaccination in the United Kingdom
Invasive pneumococcal disease and the potential for prevention by vaccination in the United Kingdom
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DOI：
10.1016/j.jinf.2006.09.002
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发表时间：
2007-05-01
影响因子：
28.2
通讯作者：
Dockrell, D. H.
中科院分区：
文献类型：
--
作者：
Parsons, H. K.;Metcalf, S. C.;Dockrell, D. H.
目的：尽管进行了抗菌治疗，侵袭性肺炎球菌疾病（IPD）仍与高死亡率相关，但可以通过肺炎球菌疫苗接种来预防。英国住院成人在发生 IPD 之前接受肺炎球菌荚膜多糖疫苗接种的程度尚不清楚。 方法：我们对 1992 年至 2000 年期间英国谢菲尔德两家教学医院收治的 IPD 成人进行了一项回顾性队列研究。确定了肺炎球菌疫苗接种情况、IPD 危险因素、死亡和残疾。结果：IPD 病例数为 552 例，审查了来自一个地点的 187/230 例患者记录。根据英国肺炎球菌疫苗接种指南，59% 的患者应接种疫苗，如果应用更新指南（其中包括年龄 > 65 岁作为适应症），则应接种 76% 的患者。在具有已知危险因素（不包括年龄）的患者中，只有 8% 接种了疫苗。 IPD 的死亡率为 21%，另有 6% 出现严重并发症。结论：在因 IPD 住院的患者中，既往存在危险因素的比例较高，且肺炎球菌疫苗接种率较低。 IPD 会导致显着的死亡率、发病率和经济成本，并且有可能通过提高肺炎球菌疫苗的接种率来减少这种情况。 (c) 2006 年英国感染学会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: Invasive pneumococcal disease (IPD) is associated with a high mortality despite antimicrobial therapy, but may be preventable by pneumococcal vaccination. The extent of previous exposure to pneumococcal capsular polysaccharide vaccination prior to an episode of IPD in hospitalised adults in the United Kingdom is unclear.Methods: We conducted a retrospective cohort study in adults with IPD admitted to either of two teaching hospitals in Sheffield, United Kingdom during 1992-2000. Receipt of pneumococcal vaccination, risk factors for IPD, death and disability were determined.Results: The number of cases of IPD was 552 and 187/230 patient records from one site were reviewed. According to UK pneumococcal vaccination guidelines 59% of patients should have received the vaccine and 76% of patients if updated guidelines, which include age > 65 years as an indication, are applied. In patients with known risk factors, excluding age, only 8% had been vaccinated. The mortality from IPD was 21% and an additional 6% suffered major complications.Conclusions: In patients hospitalised with IPD there is a high rate of pre-existing risk factors and a tow rate of administration of pneumococcal vaccination. IPD incurs significant mortality, morbidity and economic cost and there is potential for reducing this by improved uptake of pneumococcal vaccination. (c) 2006 The British Infection Society. Published by Elsevier Ltd. All rights reserved.