DECREASED HAEMOPHILUS COLONIZATION IN CHILDREN VACCINATED WITH HAEMOPHILUS-INFLUENZAE TYPE-B CONJUGATE VACCINE
DECREASED HAEMOPHILUS COLONIZATION IN CHILDREN VACCINATED WITH HAEMOPHILUS-INFLUENZAE TYPE-B CONJUGATE VACCINE
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DOI：
10.1016/s0022-3476(05)83529-2
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发表时间：
1993-04-01
影响因子：
5.1
通讯作者：
GRANOFF, DM
中科院分区：
文献类型：
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作者：
MURPHY, TV;PASTOR, P;GRANOFF, DM
目的：自从美国引入结合疫苗以来，未接种疫苗的儿童侵袭性嗜血杆菌疾病的发病率意外下降。这项研究的目的是确定联合疫苗接种是否能减少b型流感嗜血杆菌的定植。设计：这项研究是1987年10月至1989年9月期间在托儿所的儿童中b型流感嗜血杆菌在咽部定植的前瞻性双月调查。从病历中确定接种情况。对象：我们从283名18~59个月的健康儿童中获得1188份咽培养物；51名儿童接种了非结合多糖疫苗，89名儿童接种了结合疫苗(94%的白喉类毒素)。测量和结果：采用多因素分析来检验接种状况与b型流感嗜血杆菌定殖率之间的关联。在已知接触过至少一个培养阳性儿童的儿童中，在不匹配分析中，结合疫苗预防b型流感嗜血杆菌定植的有效性为%(95%可信区间：5%，86%；p=0.02)，在匹配分析中为81%(95%可信区间：7%，96%；P-0.02)。结论：联合接种可减少b型流感嗜血杆菌在咽部的定植，从而减少该病原体在健康儿童中的传播。
Objective: The incidence of invasive Haemophilus disease has unexpectedly decreased in unvaccinated children since the introduction of conjugate vaccine in the United States. The purpose of this study was to determine whether conjugate vaccination decreases colonization with Haemophilus influenzae type b.Design: This study was a prospective, bimonthly survey of pharyngeal colonization with H. influenzae type b in children attending day care from October 1987 through September 1989. Vaccination status was determined from the medical record.Subjects: We obtained 1188 pharyngeal cultures from 283 healthy children, 18 to 59 months of age; 51 children had received unconjugated polysaccharide vaccine (PRP), and 89 had received conjugate vaccine (94% PRP-diphtheria toxoid).Measurements and results: Multivariate analysis was used to test the possibility of an association between vaccination status and the rate of colonization with H. influenzae type b. Among children known to be exposed to at least one child with a positive culture result, the efficacy of conjugate vaccination to prevent H. influenzae type b colonization in an unmatched analysis was 64% (95% confidence interval: 5%, 86%; p = 0.02) and in a matched analysis 81% (95% confidence interval: 7%, 96%; p - 0.02). No effect on colonization was found with PRP vaccination.Conclusions: Conjugate vaccination decreases H. influenzae type b pharyngeal colonization and thereby may decrease transmission of this agent among healthy children.