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首页> 外文期刊>Vaccine >Prospective epidemiologic surveillance of invasive pneumococcal diseaseTI Prospective epidemiologic surveillance of invasive pneumococcal disease and pneumonia in children in San Jose, Costa Rica
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Prospective epidemiologic surveillance of invasive pneumococcal diseaseTI Prospective epidemiologic surveillance of invasive pneumococcal disease and pneumonia in children in San Jose, Costa Rica

机译：侵袭性肺炎球菌疾病的前瞻性流行病学监测TI哥斯达黎加圣何塞儿童侵袭性肺炎球菌病和肺炎的前瞻性流行病学监测

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Background: Streptococcus pneumoniae (SP) is the leading cause of vaccine-preventable death in children <5 years of age, globally. This surveillance determined incidence rates of invasive pneumococcal disease (IPD), clinical and chest radiograph-confirmed pneumonia (CXR+Pn); and SP serotype distribution and antimicrobial susceptibility in children in San Jose, Costa Rica. Methods: This was a 2-year prospective, population-based surveillance conducted in 2007-2009 in children aged 28 days to 36 months presenting to participating healthcare centers. Eligibility criteria for study inclusion were as follows: temperature >= 39.0 degrees C within 24h and/or clinical suspicion of IPD or pneumonia. Results: 8801 subjects were enrolled. Median age: 14.5 months. A total of 25 children had invasive pneumococcal disease with S. pneumoniae isolated from nonduplicative cultures (22) or detected solely by PCR and a clinical picture consistent with IPD (3). Sources of positive cultures (some children had >1 positive culture) were: blood (20), pleural fluid (4), and cerebrospinal fluid (3). Of the 3 cases detected solely by PCR, 2 were from cerebrospinal fluid and 1 from pleural fluid. The overall IPD incidence rates for culture-positive only cases for children aged 28 days to <3 years was 33.7/100,000 per year for years 1 and 2 combined. Age stratification of culture-positive only subjects showed a peak during year 1(106.8/100,000) in children 28 days to <6 months of age group, and in year 2 (45.5/100,000) in children 12 months to <24 months of age group. Most common serotypes were 14(28.6%), followed by 3, 4, 6A, 19A, and 22F (9.5% each). Of 22 nonduplicative IPD isolates, 42.9% were penicillin- and trimethoprim/sulfamethoxazole nonsusceptible isolates. Consideration of PCR-positive cases increases the incidence of IPD for children aged 28 days to <3 years to 46.0/100,000. Overall incidence of clinical pneumonia and CXR+Pn was 1968/100,000 and 551/100,000, respectively. Conclusions: There is a considerable burden of IPD and pneumonia in children in San Jose. These epidemiologic data serve as a baseline to evaluate the effectiveness of the incorporation of new conjugate pneumococcal vaccines into the National Immunization Program in Costa Rican children
机译：背景：全球范围内，肺炎链球菌（SP）是5岁以下儿童可预防疫苗死亡的主要原因。该监测确定了侵袭性肺炎球菌疾病（IPD），临床和胸部X线照片确诊的肺炎（CXR + Pn）的发生率;哥斯达黎加圣何塞儿童的血吸虫和SP血清型分布和抗药性。方法：这是2007年至2009年对参加参与的医疗中心的28天至36个月大的儿童进行的为期2年的前瞻性人群监测。纳入研究的资格标准如下：24小时内温度> = 39.0摄氏度和/或临床怀疑患有IPD或肺炎。结果：招募了8801名受试者。中位数年龄：14.5个月。共有25名儿童患有侵袭性肺炎球菌病，其中肺炎链球菌是从非重复性培养物中分离出来的（22）或仅通过PCR和与IPD一致的临床影像检测到的（3）。阳性培养物的来源（一些儿童的阳性培养物> 1）包括：血液（20），胸膜液（4）和脑脊液（3）。仅通过PCR检测的3例病例中，有2例来自脑脊液，1例来自胸膜液。对于第1年和第2年，年龄在28天以下且小于3岁的儿童，仅培养阳性的总IPD发生率为每年33.7 / 100,000。仅文化阳性受试者的年龄分层显示，年龄在28天至<6个月的儿童在第一年（106.8 / 100,000）达到峰值，在12个月至<24个月的儿童在第二年（45.5 / 100,000）达到峰值。组。最常见的血清型为14（28.6％），其次是3、4、6A，19A和22F（每种为9.5％）。在22种非重复IPD分离株中，有42.9％是青霉素和甲氧苄啶/磺胺甲恶唑不敏感株。考虑到PCR阳性病例，将28天至3岁以下儿童的IPD发生率增加到46.0 / 100,000。临床肺炎和CXR + Pn的总发生率分别为1968 / 100,000和551 / 100,000。结论：圣何塞儿童患IPD和肺炎的负担相当大。这些流行病学数据用作评估将新的结合肺炎球菌疫苗纳入哥斯达黎加儿童国家免疫计划的有效性的基准

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