Changing epidemiology of invasive pneumococcal disease following increased coverage with the heptavalent conjugate vaccine in Navarre, Spain
Changing epidemiology of invasive pneumococcal disease following increased coverage with the heptavalent conjugate vaccine in Navarre, Spain
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DOI：
10.1111/j.1469-0691.2009.02904.x
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发表时间：
2009-11-01
影响因子：
14.2
通讯作者：
Castilla, J.
中科院分区：
文献类型：
--
作者：
Guevara, M.;Barricarte, A.;Castilla, J.
本研究评估了西班牙纳瓦拉引入并增加七价肺炎球菌结合疫苗（PCV7）覆盖率后侵袭性肺炎球菌病（IPD）发病率的变化和分离的血清型模式。所有从通常无菌的体液中分离出肺炎球菌的病例均包括在内。比较了2001-2002年和2006-2007年期间儿童和成人IPD的发病率。到2002年底，只有11%的5岁以下儿童接种了任何剂量的PCV7，而从2007年开始，这一比例超过了50%。在5岁以下的IPD病例中，接种疫苗的比例从2001-2002年的7%增加到2006-2007年的53% （p < 0.001）。pcv7血清型的IPD发病率在5岁以下儿童中下降85% (p < 0.001)，在5-64岁人群中下降45% (p 0.10)，在>= 65岁人群中下降68% （p 0.004）。相比之下，非pcv7血清型的IPD发病率总体增加了40% （p 0.006）。所有血清型的IPD发病率在5岁以下儿童（从83 / 10万增加到72 / 10万）或总人口（从15.8 / 10万增加到16.3 / 10万）中没有显著变化。在儿童和成人中，血清型7和19A导致的病例百分比显著增加。IPD的临床表现未见明显变化。随着PCV7覆盖率的提高，儿童和成人中引起IPD的血清型模式发生了变化，尽管发病率仅略有下降。
P>The present study evaluated changes in the incidence of invasive pneumococcal disease (IPD) and the pattern of serotypes isolated in Navarre, Spain, after the introduction and increased coverage of the heptavalent pneumococcal conjugate vaccine (PCV7). All cases with isolation of pneumococcus from normally sterile bodily fluids were included. The incidence of IPD in children and adults was compared for the periods 2001-2002 and 2006-2007. By the end of 2002, only 11% of children aged < 5 years had received any dose of PCV7, whereas, beginning in 2007, the proportion exceeded 50%. Among the cases of IPD aged < 5 years, the percentage of those vaccinated increased from 7% during 2001-2002 to 53% during 2006-2007 (p < 0.001). The incidence of IPD from PCV7-serotypes decreased by 85% in children < 5 years (p < 0.001), by 45% in the population aged 5-64 years (p 0.10) and by 68% in those >= 65 years (p 0.004). By contrast, the incidence of IPD from non-PCV7 serotypes increased by 40% overall (p 0.006). The incidence of IPD from all serotypes did not change significantly in children < 5 years (from 83 to 72 per 100 000) or in the total population (from 15.8 to 16.3 per 100 000). The percentage of cases as a result of serotypes 7 and 19A increased significantly in both children and adults. No significant changes were seen in the clinical forms of IPD. The pattern of serotypes causing IPD has changed, in both children and adults, following the increased coverage of PCV7, although the incidence has been reduced only slightly.