Invasive pneumococcal disease after routine pneumococcal conjugate vaccination in children, England and Wales.
Invasive pneumococcal disease after routine pneumococcal conjugate vaccination in children, England and Wales.
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DOI：
10.3201/eid1901.120741
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发表时间：
2013-01
影响因子：
11.8
通讯作者：
Miller E
中科院分区：
文献类型：
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作者：
Ladhani SN;Slack MP;Andrews NJ;Waight PA;Borrow R;Miller E
非疫苗血清型在合并疾病的儿童中更常见。在英格兰和威尔士引入7价肺炎球菌结合疫苗(PCV7)后，我们评估了3-59个月大儿童侵袭性肺炎球菌病(IPD)的已知危险因素、临床表现和结果。在2006年9月至2010年3月期间，共有1,332名儿童发生了1,342次IPD；14.9%(198/1,332)的儿童患有合并症。与PCV7血清型引起的IPD(44/248；17.7%)相比，10价疫苗中额外3个血清型的合并症较少(15/299；5.0%)，但与额外的3个PCV13血清型(45/336；13.4%)相似，而在23价多糖疫苗(PPV23)中额外11个血清型(39/186；21.0%)和非PPV23血清型(38/138；27.5%)的并存率较高。PCV7失败52例(3.9%)，IPD复发9例(0.7%)。病死率为4.4%(58/1332)，但脑膜炎(11.0%)和儿童合并症(9.1%)的病死率较高。因此，在由非PCV13血清型引起的IPD儿童中，合并症更为普遍，并与增加的病死率相关。
Nonvaccine serotypes occur more often among children with comorbid conditions. We assessed known risk factors, clinical presentation, and outcome of invasive pneumococcal disease (IPD) in children 3–59 months of age after introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in England and Wales. During September 2006–March 2010, a total of 1,342 IPD episodes occurred in 1,332 children; 14.9% (198/1,332) had comorbidities. Compared with IPD caused by PCV7 serotypes (44/248; 17.7%), comorbidities were less common for the extra 3 serotypes in the 10-valent vaccine (15/299; 5.0%) but similar to the 3 additional PCV13 serotypes (45/336; 13.4%) and increased for the 11 extra serotypes in 23-valent polysaccharide vaccine (PPV23) (39/186; 21.0%) and non-PPV23 serotypes (38/138; 27.5%). Fifty-two (3.9%) cases resulted from PCV7 failure; 9 (0.7%) case-patients had recurrent IPD. Case-fatality rate was 4.4% (58/1,332) but higher for meningitis (11.0%) and children with comorbidities (9.1%). Thus, comorbidities were more prevalent in children with IPD caused by non-PCV13 serotypes and were associated with increased case fatality.