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首页> 外文期刊>Vaccine >Comparative incidence dynamics and serotypes of meningitis, bacteremic pneumonia and other-IPD in young children in the PCV era: Insights from Israeli surveillance studies
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Comparative incidence dynamics and serotypes of meningitis, bacteremic pneumonia and other-IPD in young children in the PCV era: Insights from Israeli surveillance studies

机译：PCV时代幼儿脑膜炎，菌脑膜和其他IPD的比较发病率动态和血清型：以色列监测研究的见解

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IntroductionWidespread introduction of pneumococcal conjugated vaccines (PCVs) impacted on invasive pneumococcal disease (IPD). However, IPD reduction may not be similar in all outcomes within IPD.We assessed PCV7/PCV13 impact on pneumococcal meningitis, bacteremic pneumonia (BP) and other (non-meningitis, non-pneumonia) IPD episodes in children 5years in Israel.MethodsA prospective, population-based, active nationwide surveillance.All pneumococcal invasive episodes with positive blood/CSF cultures, July 2000 through June 2016, were included. Three sub-periods were defined: pre-PCV (2000–2008), PCV7 (2009–2011) and PCV13 (2014–2016). Incidence rate ratios (IRRs) were calculated.ResultsOverall, 4321 episodes were recorded; 456 (10.6%) meningitis, 1478 (34.2%) pneumonia and 2387 (55.2%) other-IPD.In the pre-PCV period, proportion of serotypes in PCV13, but not in PCV7 (mainly serotypes 1, 5 and 19A) was higher in BP (43.3%) compared with other-IPD episodes (32.8%, p0.001) and similar to that of meningitis (37.6%, p=0.1). The proportion of episodes in children 12months was higher in meningitis (52.1%) compared with pneumonia (23.2%) and other-IPD episodes (39.5%; p0.001 for both).The declines of the 3 entities were not similar; Meningitis rate non-significantly declined by 24% (IRR=0.76; 95% CI 0.57–1.01), while BP and other-IPD rates significantly declined by 57% and 70%, respectively. In contrast to other entities, BP did not decline significantly after PCV7 introduction but started to decline only after PCV13 introduction.Rates of meningitis, pneumonia and other-IPD caused by PCV13-serotypes (VT13) substantially declined by 88%, 95% and 97%, respectively, comparing PCV13 and the pre-PCV periods. However, diseases caused by non-VT13 increased by 256%, 302% in meningitis and pneumonia, respectively, but only 116% in other-IPD.ConclusionsFollowing PCV7/PCV13 introduction, rates of episodes caused by VT13 were substantially reduced in all 3 groups. However, differences in age distribution, serotype replacement and specific serotype decrease suggest different pathogenesis and host susceptibility between the 3 entities.
机译：引入引入肺炎球菌共轭疫苗（PCV）影响侵袭性肺炎球菌（IPD）。然而，IPD中的所有结果都可能在IPD中的所有结果中不相似。我们评估了对肺炎球菌脑膜炎，菌血症肺炎（BP）和其他（非脑膜炎，非肺炎）IPD发作的PCV7 / PCV13对以色列的IPD发作的影响。 Methodsa预期，基于人口，活跃的全国范围内监测。包括血液球菌侵袭性发作，血液血液侵入性发作，包括血液/ CSF培养物，2000年7月至2016年6月。定义了三个子周期：PCV（2000-2008），PCV7（2009-2011）和PCV13（2014-2016）。计算发病率比（IRRS）。记录了4321个发作; 456（10.6％）脑膜炎，1478（34.2％）肺炎和2387（55.2％）其他 - PCV期间，PCV13中的血清型比例，但不在PCV7（主要是血清型1,9a）是与其他-IPD发作相比，BP（43.3％）较高（32.8％，P <0.001），类似于脑膜炎（37.6％，P = 0.1）。与肺炎（23.2％）和其他IPD发作相比，脑膜炎（52.1％）中脑炎（52.1％）的发作的比例较高（23.2％）（39.5％;对于两者为0.001）。3个实体的下降并不相似;脑膜炎率不显着下降24％（IRR = 0.76; 95％CI 0.57-1.01），而BP和其他IPD率分别下降57％和70％。与其他实体相比，PCV7介绍后，BP在PCV13介绍后开始下降。脑膜炎，肺炎和其他由PCV13-血清型（VT13）引起的脑膜炎（VT13）的IPD率显着下降88％，95％和97分别比较PCV13和PCV时段的％。但是，非VT13引起的疾病分别增加了256％，脑膜炎和肺炎的302％，但其他IPD中只有116％。关注PCV7 / PCV13引言，VT13引起的发作率在所有3组中显着降低。然而，年龄分布，血清型替代和特异性血清型降低的差异表明了3个实体之间的不同发病机制和宿主敏感性。

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