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目的探讨澳大利亚<2岁儿童使用7价肺炎球菌结合疫苗(7vPCV)后侵袭性肺炎球菌病(IPD)发病率和血清型趋势。方法对2002—2007年澳大利亚法定传染病监督系统获得IPD监督数据(包括年龄、本土情况和肺炎球菌分离株的血清型)和从澳大利亚统计局获得人口评估数据计算出的发病率进行分析,观察2005年普遍使用7vPCV后非本土儿童IPD血清型变化。结果 2002—2007年,所有<2岁儿童IPD发病率减少74%。而本土和非本土儿童因7vPCV血清型导致IPD总发病率均显著下降,非本土儿童非7vPCV血清型IPD发病率明显增加(9.7/100 000升至15.7/100 000)。与使用疫苗前比较,2007年非本土儿童血清型19A IPD发病率显著上升(从2.7/100 000升至8.6/100 000)。2007年19A为导致所有<2岁儿童IPD优势血清型(37.7%)。结论从2002—2007年,IPD总发病率呈下降趋势,主要因7vPCV血清型导致的IPD发病下降。然而非7vPCV血清型,尤其是19A导致非本土儿童IPD发病率明显上升。
Objective To investigate the incidence and serotype trend of invasive pneumococcal disease (IPD) in children <2 years old in Australia after using 7pPCV. Methods An analysis of IPD surveillance data (including age, indigenous status, and serotypes of pneumococcal isolates) and the incidence rates obtained from the Australian Bureau of Statistics data obtained from Australian Bureau of Surgical Infections Surveillance Systems 2002-2007 was conducted and observed 2005 Years of widespread use of 7vPCV non-indigenous children IPD serotypes change. Results Between 2002 and 2007, the incidence of IPD in all children <2 years of age was reduced by 74%. However, the incidence of IPD in both local and non-indigenous children was significantly lower due to 7vPCV serotypes, and the incidence of non-7vPCV serotypes IPD was significantly increased in non-indigenous children (9.7 / 100 000 to 15.7 / 100 000). Compared with pre-vaccine use, the incidence of non-indigenous childhood serotype 19A IPD increased significantly in 2007 (from 2.7 / 100 000 to 8.6 / 100 000). 19A 2007 was the predominant IPD serotype (37.7%) for all children <2 years of age. Conclusions From 2002 to 2007, the overall incidence of IPD showed a decreasing trend, mainly due to the decreased incidence of IPD caused by 7vPCV serotypes. However, non-7vPCV serotypes, especially 19A, led to a significant rise in the incidence of IPD in non-indigenous children.