Reduced middle ear infection with non-typeable Haemophilus influenzae, but not Streptococcus pneumoniae, after transition to 10-valent pneumococcal non-typeable H. influenzae protein D conjugate vaccine.
Reduced middle ear infection with non-typeable Haemophilus influenzae, but not Streptococcus pneumoniae, after transition to 10-valent pneumococcal non-typeable H. influenzae protein D conjugate vaccine.
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在过渡到10个价值的肺炎肺炎不可能的h. themococococococococococococococococococococococococococococococococococococcoccoccoccoccoccoccoccococococcoccocococococococococococococococococococococococococococococococococococcoccococcoccoccococe降低了中耳感染。
DOI：
10.1186/s12887-015-0483-8
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发表时间：
2015-10-19
期刊：
影响因子：
2.4
通讯作者：
Morris PS
中科院分区：
文献类型：
--
作者：
Leach AJ;Wigger C;Hare K;Hampton V;Beissbarth J;Andrews R;Chatfield M;Smith-Vaughan H;Morris PS
2009年10月，北领地儿童疫苗接种计划中的7价肺炎球菌结合疫苗（PCV 7：辉瑞公司）被10价肺炎球菌流感嗜血杆菌蛋白D结合疫苗（PHiD-CV 10; Synflorix™葛兰素史克疫苗）取代。本分析旨在确定在PHiD-CV 10时代测量的化脓性中耳炎患病率降低是否与接种疫苗的土著儿童的鼻咽（NP）携带和中耳分泌物（艾德）微生物学变化相关。2008年9月至2012年12月期间，在偏远的土著社区收集了NP和艾德的拭子。使用标准化方法培养拭子以检测中耳炎病原体。在主要分析中纳入了年龄小于3岁且接受了2剂或2剂以上PCV制剂和不超过1剂另一种PCV制剂的主要疗程的儿童;还比较了非混合单一制剂PCV方案的儿童。从PCV 7组444名儿童中的421名（95%）和PHiD-CV 10组451名儿童中的443名（98%）获得NP拭子。分别有333名（79%）和315名（71%）儿童接受了非混合PCV方案。肺炎球菌（Spn）NP携带率分别为76%和82%，不可分型流感嗜血杆菌（NTHi）携带率分别为68%和73%。从PCV 7组的60名儿童（85例穿孔）和PHiD-CV 10组的47名儿童（59例穿孔）中获得了艾德。合并双侧穿孔的数据。Spn分别从25%和18%培养，NTHi分别从61%和34%培养（p = 0.008）。观察到该人群中化脓性OM患病率的降低与OM病原体NP携带率的降低无关。与PCV 7疫苗接种儿童相比，PHiD-CV 10疫苗接种儿童中NTHi感染艾德的患病率较低。临床严重程度的变化可以通过PHiD-CV10对中耳NTHi感染的作用来解释。需要随机对照试验来回答这个问题。本文的在线版本（doi：10.1186/s12887-015-0483-8）包含补充材料，可供授权用户使用。
In October 2009, 7-valent pneumococcal conjugate vaccine (PCV7: PrevenarTM Pfizer) was replaced in the Northern Territory childhood vaccination schedule by 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10; Synflorix™ GlaxoSmithKline Vaccines). This analysis aims to determine whether the reduced prevalence of suppurative otitis media measured in the PHiD-CV10 era was associated with changes in nasopharyngeal (NP) carriage and middle ear discharge (ED) microbiology in vaccinated Indigenous children. Swabs of the NP and ED were collected in remote Indigenous communities between September 2008 and December 2012. Swabs were cultured using standardised methods for otitis media pathogens. Children less than 3 years of age and having received a primary course of 2 or more doses of one PCV formulation and not more than one dose of another PCV formulation were included in the primary analysis; children with non-mixed single formulation PCV schedules were also compared. NP swabs were obtained from 421 of 444 (95 %) children in the PCV7 group and 443 of 451 (98 %) children in the PHiD-CV10 group. Non-mixed PCV schedules were received by 333 (79 %) and 315 (71 %) children, respectively. Pneumococcal (Spn) NP carriage was 76 % and 82 %, and non-typeable Haemophilus influenzae (NTHi) carriage was 68 % and 73 %, respectively. ED was obtained from 60 children (85 perforations) in the PCV7 group and from 47 children (59 perforations) in the PHiD-CV10 group. Data from bilateral perforations were combined. Spn was cultured from 25 % and 18 %, respectively, and NTHi was cultured from 61 % and 34 % respectively (p = 0.008). The observed reduction in the prevalence of suppurative OM in this population was not associated with reduced NP carriage of OM pathogens. The prevalence of NTHi-infected ED was lower in PHiD-CV10 vaccinated children compared to PCV7 vaccinated children. Changes in clinical severity may be explained by the action of PHiD-CV10 on NTHi infection in the middle ear. Randomised controlled trials are needed to answer this question. The online version of this article (doi:10.1186/s12887-015-0483-8) contains supplementary material, which is available to authorized users.