Pneumococcal meningitis in adults in 2014-2018 after introduction of pediatric 13-valent pneumococcal conjugate vaccine in Japan.
Pneumococcal meningitis in adults in 2014-2018 after introduction of pediatric 13-valent pneumococcal conjugate vaccine in Japan.
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DOI：
10.1038/s41598-022-06950-w
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发表时间：
2022-02-23
影响因子：
4.6
通讯作者：
Adult IPD Study Group
中科院分区：
文献类型：
--
作者：
Chang B;Tamura K;Fujikura H;Watanabe H;Tanabe Y;Kuronuma K;Fujita J;Oshima K;Maruyama T;Abe S;Kasahara K;Nishi J;Kubota T;Kinjo Y;Serizawa Y;Shimbashi R;Fukusumi M;Shimada T;Sunagawa T;Suzuki M;Oishi K;Adult IPD Study Group
我们评估了2014-2018年儿童13价肺炎球菌结合疫苗（PCV 13）对日本成人肺炎球菌脑膜炎的影响，方法是比较患有侵袭性肺炎球菌疾病的成人（n = 222）和没有脑膜炎的成人（n = 1258）的流行病学特征。2016-2018年肺炎球菌脑膜炎年发病率为0.20-0.26例/10万人口。脑膜炎患者的年龄（p < 0.001）和病死率（p = 0.003）明显低于非脑膜炎患者。无脾/脾功能减退或脾切除患者发生脑膜炎的几率较高（校正比值比[aOR] 2.29，95% CI 1.27-4.14），血清型10A（aOR 3.26，95% CI 2.10-5.06）或23 A（aOR 3.91，95% CI 2.47-6.19），但年龄≥ 65岁的患者较低（aOR 0.59，95% CI 0.44-0.81）。PCV 13对非脑膜炎有间接影响，但由于非PCV 13血清型的增加，其对脑膜炎的影响有限。在脑膜炎分离株中，分别有78株（35.1%）和3株（1.4%）对青霉素G或头孢曲松耐药。我们还证实了pbp 1bA 641 C突变与脑膜炎相关（aOR 2.92，95%CI 1.51-5.65）。
We assessed the impact of the pediatric 13-valent pneumococcal conjugate vaccine (PCV13) on pneumococcal meningitis in adults in Japan in 2014–2018 by comparing epidemiological characteristics of adults with invasive pneumococcal disease with (n = 222) and without (n = 1258) meningitis. The annual incidence of pneumococcal meningitis in 2016–2018 was 0.20–0.26 cases/100,000 population. Age (p < 0.001) and case fatality rate (p = 0.003) were significantly lower in patients with meningitis than in those without meningitis. The odds of developing meningitis were higher in asplenic/hyposplenic or splenectomized patients (adjusted odds ratio [aOR] 2.29, 95% CI 1.27–4.14), for serotypes 10A (aOR 3.26, 95% CI 2.10–5.06) or 23A (aOR 3.91, 95% CI 2.47–6.19), but lower for those aged ≥ 65 years (aOR 0.59, 95% CI 0.44–0.81). PCV13 had an indirect effect on nonmeningitis, but its impact on meningitis was limited because of an increase in non-PCV13 serotypes. Of meningitis isolates, 78 (35.1%) and 3 (1.4%) were penicillin G- or ceftriaxone-resistant, respectively. We also confirmed an association of the pbp1bA641C mutation with meningitis (aOR 2.92, 95% CI 1.51–5.65).
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