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首页> 外文期刊>BMC Pediatrics >Reduced middle ear infection with non-typeable Haemophilus influenzae, but not Streptococcus pneumoniae, after transition to 10-valent pneumococcal non-typeable H. influenzae protein D conjugate vaccine
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Reduced middle ear infection with non-typeable Haemophilus influenzae, but not Streptococcus pneumoniae, after transition to 10-valent pneumococcal non-typeable H. influenzae protein D conjugate vaccine

机译：过渡到10价肺炎球菌不可分型流感嗜血杆菌D结合蛋白疫苗后，减少了不可分型流感嗜血杆菌对中耳的感染，但对肺炎链球菌无效

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Background In October 2009, 7-valent pneumococcal conjugate vaccine (PCV7: Prevenar TM Pfizer) was replaced in the Northern Territory childhood vaccination schedule by 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10; Synflorix? GlaxoSmithKline Vaccines). This analysis aims to determine whether the reduced prevalence of suppurative otitis media measured in the PHiD-CV10 era was associated with changes in nasopharyngeal (NP) carriage and middle ear discharge (ED) microbiology in vaccinated Indigenous children. Methods Swabs of the NP and ED were collected in remote Indigenous communities between September 2008 and December 2012. Swabs were cultured using standardised methods for otitis media pathogens. Children less than 3?years of age and having received a primary course of 2 or more doses of one PCV formulation and not more than one dose of another PCV formulation were included in the primary analysis; children with non-mixed single formulation PCV schedules were also compared. Results NP swabs were obtained from 421 of 444 (95?%) children in the PCV7 group and 443 of 451 (98?%) children in the PHiD-CV10 group. Non-mixed PCV schedules were received by 333 (79?%) and 315 (71?%) children, respectively. Pneumococcal (Spn) NP carriage was 76?% and 82?%, and non-typeable Haemophilus influenzae (NTHi) carriage was 68?% and 73?%, respectively. ED was obtained from 60 children (85 perforations) in the PCV7 group and from 47 children (59 perforations) in the PHiD-CV10 group. Data from bilateral perforations were combined. Spn was cultured from 25?% and 18?%, respectively, and NTHi was cultured from 61?% and 34?% respectively (p?=?0.008). Conclusions The observed reduction in the prevalence of suppurative OM in this population was not associated with reduced NP carriage of OM pathogens. The prevalence of NTHi-infected ED was lower in PHiD-CV10 vaccinated children compared to PCV7 vaccinated children. Changes in clinical severity may be explained by the action of PHiD-CV10 on NTHi infection in the middle ear. Randomised controlled trials are needed to answer this question.
机译：背景技术2009年10月，在北领地儿童时期的疫苗接种计划中，用10价肺炎球菌流感嗜血杆菌流感病毒D结合疫苗（PHiD-CV10; 7）取代了7价肺炎球菌结合疫苗（PCV7：Prevenar TM Pfizer）。 Synflorix？GlaxoSmithKline疫苗）。该分析旨在确定在PHiD-CV10时代测量的化脓性中耳炎的患病率是否与接种疫苗的土著儿童的鼻咽（NP）运送和中耳放电（ED）微生物学变化有关。方法在2008年9月至2012年12月间，在偏远的原住民社区中采集NP和ED的拭子。对拭子进行标准化培养以治疗中耳炎病原体。初次分析中包括年龄小于3岁且接受了2个或更多剂量的一种PCV制剂和不超过1剂另一种PCV制剂的初次病程的儿童;还比较了非混合单一配方PCV时间表的儿童。结果PCV7组的444名儿童中有421名（95％）获得NP拭子，PHiD-CV10组的451名儿童中有443名（98％）获得了棉签。非混合PCV时间表分别由333（79％）和315（71％）儿童接收。肺炎球菌（Spn）NP携带率分别为76％和82％，不可分型流感嗜血杆菌（NTHi）携带率分别为68％和73％。 ED来自PCV7组的60名儿童（85个穿孔）和PHiD-CV10组的47名儿童（59个穿孔）。合并了双侧穿孔的数据。 Spn分别从25％和18％培养，NTHi分别从61％和34％培养（p ＝ 0.008）。结论在该人群中观察到的化脓性OM患病率降低与OM病原体的NP携带减少无关。与PCV7疫苗接种的儿童相比，PHiD-CV10疫苗接种的儿童NTHi感染的ED患病率较低。 PHiD-CV10对中耳NTHi感染的作用可能解释了临床严重程度的变化。需要随机对照试验来回答这个问题。

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