Continued impact of pneumococcal conjugate vaccine on carriage in young children.
Continued impact of pneumococcal conjugate vaccine on carriage in young children.
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DOI：
10.1542/peds.2008-3099
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发表时间：
2009-07
期刊：
影响因子：
8
通讯作者：
Finkelstein JA
中科院分区：
文献类型：
--
作者：
Huang SS;Hinrichsen VL;Stevenson AE;Rifas-Shiman SL;Kleinman K;Pelton SI;Lipsitch M;Hanage WP;Lee GM;Finkelstein JA
目的是评估肺炎链球菌血清型和抗生素耐药性在幼儿中的一系列变化，并评估七价肺炎球菌结合疫苗（PCV 7）是否改变了携带的风险因素。鼻咽标本和问卷/病历数据来自2000-2001年和2003-2004年冬季马萨诸塞州16个社区和2006-2007年8个社区3个月至<7岁初级保健实践中的儿童。用肺炎链球菌分离株进行抗菌药物敏感性试验和血清分型。在2000-2001年、2003-2004年和2006-2007年的采样期间，我们分别采集了678、988和972份标本。2006-2007年，非PCV 7血清型的携带率从15%增加到19%和29%（P <0.001），疫苗血清型减少到携带血清型的3%。几种非PCV 7血清型（包括19 A、35 B和23 A）的相对贡献在整个采样期间增加。到2007年，常见的携带血清型包括19 A（16%），6A（12%），15 B/C（11%），35 B（9%）和11 A（8%），高流行率血清型似乎具有更大比例的青霉素不敏感性。在多变量模型中，肺炎球菌携带的常见预测因素，如儿童保育出勤率，上呼吸道感染，以及年幼的兄弟姐妹的存在，仍然存在。肺炎链球菌携带的疫苗血清型在幼儿中实际消失，迅速被青霉素不敏感的非疫苗血清型，特别是19 A和35 B所取代。除了最高风险的年龄组，以前的携带预测因素，如儿童保育出勤率和年幼兄弟姐妹的存在，并没有被疫苗改变。
The goals were to assess serial changes in Streptococcus pneumoniae serotypes and antibiotic resistance in young children and to evaluate whether risk factors for carriage have been altered by heptavalent pneumococcal conjugate vaccine (PCV7). Nasopharyngeal specimens and questionnaire/medical record data were obtained from children 3 months to <7 years of age in primary care practices in 16 Massachusetts communities during the winter seasons of 2000–2001 and 2003–2004 and in 8 communities in 2006–2007. Antimicrobial susceptibility testing and serotyping were performed with S pneumoniae isolates. We collected 678, 988, and 972 specimens during the sampling periods in 2000–2001, 2003–2004, and 2006–2007, respectively. Carriage of non-PCV7 serotypes increased from 15% to 19% and 29% (P < .001), with vaccine serotypes decreasing to 3% of carried serotypes in 2006–2007. The relative contribution of several non-PCV7 serotypes, including 19A, 35B, and 23A, increased across sampling periods. By 2007, commonly carried serotypes included 19A (16%), 6A (12%), 15B/C (11%), 35B (9%), and 11A (8%), and high-prevalence serotypes seemed to have greater proportions of penicillin nonsusceptibility. In multivariate models, common predictors of pneumococcal carriage, such as child care attendance, upper respiratory tract infection, and the presence of young siblings, persisted. The virtual disappearance of vaccine serotypes in S pneumoniae carriage has occurred in young children, with rapid replacement with penicillin-nonsusceptible nonvaccine serotypes, particularly 19A and 35B. Except for the age group at highest risk, previous predictors of carriage, such as child care attendance and the presence of young siblings, have not been changed by the vaccine.
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影响因子：
6.7
作者：
Brueggemann, Angela B.;Pai, Rekha;Beall, Bernard
通讯作者：
Beall, Bernard
影响因子：
--
作者：
DWASS, M
通讯作者：
DWASS, M
影响因子：
3.6
作者：
Dagan, Ron;Barkai, Galia;Greenberg, David
通讯作者：
Greenberg, David
DOI：
10.1016/j.ambp.2005.11.005
发表时间：
2006-05-01
期刊：
AMBULATORY PEDIATRICS
影响因子：
--
作者：
Hare, Marion E.;Gaur, Aditya H.;Shorr, Ronald I.
通讯作者：
Shorr, Ronald I.
影响因子：
11.8
作者：
Byington, CL;Samore, MH;Pavia, AT
通讯作者：
Pavia, AT