Sustained Reductions in Invasive Pneumococcal Disease in the Era of Conjugate Vaccine
Sustained Reductions in Invasive Pneumococcal Disease in the Era of Conjugate Vaccine
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DOI：
10.1086/648593
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发表时间：
2010-01-01
影响因子：
6.4
通讯作者：
Moore, Matthew R.
中科院分区：
文献类型：
--
作者：
Pilishvili, Tamara;Lexau, Catherine;Moore, Matthew R.
背景在美国儿童中使用7价肺炎球菌结合疫苗（PCV 7）7年后，评估侵袭性肺炎球菌病（IPD）发病率的变化。1998 - 2007年期间，8个活跃的基于人群的监测点确定了经病理学证实的IPD病例。我们比较了2007年与1998 - 1999年（PCV7之前）的总体、年龄组特异性、症状特异性和血清型特异性IPD发病率，并评估了新结合疫苗制剂的潜在血清型覆盖率。总体和PCV 7型IPD发病率分别下降了45%（从每10万人24.4例降至13.5例）和94%（从每10万人15.5例降至1.0例）（所有年龄组P <0.01）。由血清型19A和其他非PCV 7型引起的IPD的发病率分别从每10万人0.8例增加到2.7例，从每10万人6.1例增加到7.9例（所有年龄组P <0.01）。非PCV 7型引起的脑膜炎和侵袭性肺炎的发生率在所有年龄组中均有所增加（P <0.05），而这些血清型引起的原发性菌血症的发生率没有变化。在2006 - 2007年，PCV7型引起了2%的IPD病例，而研究中的13价结合疫苗中包含的6种额外血清型引起了63%的儿童IPD病例! 5岁。结论。7年后，在美国引入PCV 7后，IPD的显著降低仍然很明显。血清型19A和其他非PCV7型引起的IPD率有所增加，但相对于PCV7型IPD的减少仍较低。
Background. Changes in invasive pneumococcal disease (IPD) incidence were evaluated after 7 years of 7-valent pneumococcal conjugate vaccine (PCV7) use in US children.Methods. Laboratory-confirmed IPD cases were identified during 1998-2007 by 8 active population-based surveillance sites. We compared overall, age group-specific, syndrome-specific, and serotype group-specific IPD incidence in 2007 with that in 1998-1999 (before PCV7) and assessed potential serotype coverage of new conjugate vaccine formulations.Results. Overall and PCV7-type IPD incidence declined by 45% (from 24.4 to 13.5 cases per 100,000 population) and 94% (from 15.5 to 1.0 cases per 100,000 population), respectively (P < .01 for all age groups). The incidence of IPD caused by serotype 19A and other non-PCV7 types increased from 0.8 to 2.7 cases per 100,000 population and from 6.1 to 7.9 cases per 100,000 population, respectively (P < .01 for all age groups). The rates of meningitis and invasive pneumonia caused by non-PCV7 types increased for all age groups (P < .05), whereas the rates of primary bacteremia caused by these serotypes did not change. In 2006-2007, PCV7 types caused 2% of IPD cases, and the 6 additional serotypes included in an investigational 13-valent conjugate vaccine caused 63% of IPD cases among children ! 5 years-old.Conclusions. Dramatic reductions in IPD after PCV7 introduction in the United States remain evident 7 years later. IPD rates caused by serotype 19A and other non-PCV7 types have increased but remain low relative to decreases in PCV7-type IPD.