Aetiology of paediatric pneumonia after the introduction of pneumococcal conjugate vaccine.
Aetiology of paediatric pneumonia after the introduction of pneumococcal conjugate vaccine.
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DOI：
10.1183/09031936.00199112
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发表时间：
2013-12
期刊：
影响因子：
--
通讯作者：
North East of England Paediatric Respiratory Infection Study Group
中科院分区：
文献类型：
--
作者：
Elemraid MA;Sails AD;Eltringham GJ;Perry JD;Rushton SP;Spencer DA;Thomas MF;Eastham KM;Hampton F;Gennery AR;Clark JE;North East of England Paediatric Respiratory Infection Study Group
我们描述了2006年引入肺炎球菌结合疫苗（PCV）计划前后儿童社区获得性肺炎的病因。在2001-2002年（疫苗接种前）和2009-2011年（疫苗接种后）对0-16岁的住院放射学确诊肺炎儿童进行了前瞻性研究。调查包括培养、血清学、免疫荧光抗体和尿抗原检测，在疫苗后研究中增加使用PCR检测和扩大病原体组。分别有241名和160名儿童参加了疫苗接种前和疫苗接种后的研究（73%的儿童年龄<5岁）。接种后（61%）对致病病原体的鉴定高于接种前（48.5%）（p=0.019）。疫苗接种后和疫苗接种前研究的细菌感染率没有差异（17.5%与24%，p=0.258）。接种后（19.5%，p=0.021）比接种前（5%，p = 0.015）更常发现病毒（31%）和混合（12.5%）感染。疫苗接种前和接种后研究中确定的肺炎球菌感染率相当（14.7% vs 17.4%，p=0.557）。与培养相比，使用PCR时，接种后肺炎球菌感染的诊断得到改善（21.6% vs 6%，p=0.0004）。接种后，在75%（18/24）中鉴定出PCV 13中包含的血清型，但未鉴定出PCV 7。非疫苗肺炎球菌血清型感染仍然是英国儿童肺炎的重要原因。肺炎球菌结合疫苗接种计划后儿童社区获得性肺炎的病因http://ow.ly/p9Wub
We describe the aetiology of community-acquired pneumonia in children before and after the introduction of the pneumococcal conjugate vaccination (PCV) programme in 2006. Prospective studies were conducted in 2001–2002 (pre-vaccine) and 2009–2011 (post-vaccine) of children aged 0–16 years with radiologically confirmed pneumonia seen in hospital. Investigations included culture, serology, immunofluorescence antibody and urine antigen testing, with an increased use of PCR assays and expanded panels of pathogens in the post-vaccine study. 241 and 160 children were enrolled in the pre- and post-vaccine studies, respectively (73% aged <5 years). Identification of a causative pathogen was higher post-vaccination (61%) than pre-vaccination (48.5%) (p=0.019). Rates of bacterial infections were not different between post- and pre-vaccine studies (17.5% versus 24%, p=0.258). Viral (31%) and mixed (12.5%) infections were found more often post-vaccination (19.5%, p=0.021) than pre-vaccination (5%, p=0.015). Rates of identified pneumococcal infections were comparable between pre- and post-vaccine studies (14.7% versus 17.4%, p=0.557). Diagnosis of pneumococcal infection post-vaccination improved when PCR was used compared to culture (21.6% versus 6%, p=0.0004). Serotypes included in PCV13 but not PCV7 were identified in 75% (18 out of 24) post-vaccination. Infection with nonvaccine pneumococcal serotypes continues to be a significant cause of pneumonia in children in the UK. Aetiology of community-acquired pneumonia in children following a pneumococcal conjugate vaccination programme http://ow.ly/p9Wub
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影响因子：
4.2
作者：
Elemraid, M. A.;Rushton, S. P.;Clark, J. E.
通讯作者：
Clark, J. E.
影响因子：
8.8
作者：
Fenwick, F.;Young, B.;Toms, G. L.
通讯作者：
Toms, G. L.
影响因子：
11.8
作者：
Michelow, IC;Lozano, J;McCracken, GH
通讯作者：
McCracken, GH
影响因子：
10
作者：
Harris, Michael;Clark, Julia;Thomson, Anne
通讯作者：
Thomson, Anne
影响因子：
5.2
作者：
Drummond, P;Clark, J;Cant, A
通讯作者：
Cant, A