Pneumococcal vaccination of children.
Pneumococcal vaccination of children.
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DOI：
10.1053/spid.2002.125858
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发表时间：
2002-07-01
期刊：
影响因子：
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通讯作者：
Overturf, Gary D
中科院分区：
文献类型：
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作者：
Overturf, Gary D
肺炎链球菌是2岁以下儿童侵袭性细菌感染的最常见原因，在6至12个月大时达到高峰。肺炎球菌还导致许多肺炎、鼻窦炎和中耳炎。患有镰状细胞病、后天或先天性脾切除术或人类免疫缺陷病毒感染的儿童在出生后头5年的侵袭性感染发生率比健康儿童高20至100倍。其他健康的儿童，如美洲印第安人、阿拉斯加原住民或非裔美国人后裔，也有很高的侵袭性感染率，那些参加家庭护理的儿童可能会略有增加风险。肺炎球菌多糖多价疫苗已有20多年的历史，但由于无法在2岁以下儿童中诱导保护性抗体反应和缺乏免疫学记忆，其对儿童的实用性有限。相比之下，肺炎球菌蛋白结合疫苗在6个月以下的婴儿中诱导推定的保护性反应，免疫记忆在给予加强剂量后进一步增强反应。目前，单一七价肺炎球菌蛋白结合疫苗在美国获得使用许可，并建议从2个月大的儿童开始对所有儿童进行常规接种。对于年龄在24至59个月之间、感染侵袭性疾病风险较高的儿童，也建议使用该药。
Streptococcus pneumoniae is the most frequent cause of invasive bacterial infection in children younger than 2 years of age, reaching a peak incidence at 6 to 12 months of age. Pneumococci also cause many cases of pneumonia, sinusitis, and otitis media. Incidence rates of invasive infection in children with sickle cell disease, acquired or congenital splenectomy, or human immunodeficiency virus infection are 20- to 100-fold higher than are those of healthy children during the first 5 years of life. Other healthy children, such as those of American Indian, Native Alaskan, or African American descent, also have high rates of invasive infection, and those children enrolled in out-of-home care may have modestly increased risks. Pneumococcal polysaccharide polyvalent vaccines have been available for more than 2 decades but are limited in their usefulness for children because of their inability to induce protective antibody responses in children younger than 2 years of age and lack of immunologic memory. In contrast, pneumococcal protein conjugate vaccines induce presumptive protective responses in infants younger than 6 months, and immunologic memory further enhances responses after booster doses are given. Currently, a single heptavalent pneumococcal protein conjugate vaccine is licensed for use in the United States and is recommended for routine administration to all children, beginning at 2 months of age. It also is recommended for children between 24 and 59 months of age who are at high risk of acquiring invasive disease.