The rise and fall of pneumococcal serotypes carried in the PCV era
The rise and fall of pneumococcal serotypes carried in the PCV era
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DOI：
10.1016/j.vaccine.2017.01.035
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发表时间：
2017-03-01
期刊：
影响因子：
5.5
通讯作者：
Clarke, Stuart C.
中科院分区：
文献类型：
--
作者：
Devine, Vanessa T.;Cleary, David W.;Clarke, Stuart C.
肺炎链球菌是世界范围内脑膜炎、败血症和肺炎的主要原因。因此，自2006年以来，使用肺炎球菌结合疫苗（PCV）的疫苗接种一直是英国儿童免疫接种计划的一部分。在这里，我们描述了2006年至2013年7个冬季期间，在英国一家大型医院儿科就诊的5岁以下儿童中肺炎球菌携带率。S.从2006/7至2012/13年10月至3月连续7个冬季采集的鼻咽拭子（n = 2267）中分离出肺炎克雷伯氏菌（n = 696）。这包括2006年引入七价肺炎球菌结合疫苗（PCV 7）后的时期，以及2010年引入PCV 13前后的时期。我们发现PCV 13疫苗接种后三年（2010/11至2012/13），PCV 13疫苗血清型（VT）有所下降。血清型6A代表在实施PCV 13后唯一观察到的VT，所有其他（包括PCV 7血清型）均未携带。总体肺炎球菌携带，归因于非VT（NVT），是一致的，在所有采样年的平均值为314%。10种最常见的NVT是6C、11 A、15 B、23 B、15 A、21、22 F、35 F、23 A和15 C。然而，注意到每种疾病的流行率都有波动。将2006/07年与2012/13年的患病率进行比较，在PCV实施过程中，仅15 A显着增加（p值为0.003）。这些数据支持越来越多的证据表明PCV的主要影响是由于通过减少或消除侵入性VT血清型的携带而引起的群体免疫。随着IPD越来越多地归因于非疫苗血清型，对携带数据的监测继续作为疫苗设计和公共卫生政策的预警系统，这些政策需要携带的肺炎球菌血清型和IPD归因的血清型数据的连续数据。(C)2017爱思唯尔有限公司版权所有
Streptococcus pneumoniae is a major cause of meningitis, sepsis and pneumonia worldwide. Vaccination using pneumococcal conjugate vaccines (PCV) has therefore been part of the UK's childhood immunisation programme since 2006. Here we describe pneumococcal carriage rates in children under five years of age attending the paediatric department of a large UK hospital in response to vaccine implementation over seven winter seasons from 2006 to 2013. S. pneumoniae (n = 696) were isolated from nasopharyngeal swabs (n = 2267) collected during seven consecutive winters, October to March, 2006/7 to 2012/13. This includes the period immediately following the introduction of the seven-valent pneumococcal conjugate vaccine (PCV7) in 2006 in addition to pre- and post-PCV13 introduction in 2010. We show a decrease in PCV13 vaccine serotypes (VT) in the three years following PCV13 vaccine implementation (2010/11 to 2012/13). Serotype 6A represented the only observed VT following PCV13 implementation with all others (including PCV7 serotypes) absent from carriage. Overall pneumococcal carriage, attributable to non-VT (NVT), was consistent across all sampling years with a mean of 314%. The ten most frequently isolated NVTs were 6C, 11A, 15B, 23B, 15A, 21, 22F, 35F, 23A and 15C. Fluctuations in the prevalence of each were however noted. Comparing prevalence at 2006/07 with 2012/13 only 15A was shown to have increased significantly (p value of 0.003) during the course of PCV implementation. These data support the increasing evidence that the primary effect of PCVs is due to population immunity by reducing or eliminating the carriage of invasive VT serotypes. With IPD being increasingly attributed to non-vaccine serotypes, surveillance of carriage data continues to act as an early warning system for vaccine design and public health policy that require continual data of both carried pneumococcal serotypes and IPD attributed serotype data. (C) 2017 Elsevier Ltd. All rights reserved.