在肺炎球菌疫苗接种后疾病中的血清型替代.
Daniel M Weinberger1, Richard Malley, Marc Lipsitch
1Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, USA. weinbergerdm@mail.nih.gov
Lancet (London, England)
|April 16, 2011
概括
七价肺炎球菌联合疫苗 (PCV7) 减少了疾病,但增加了非疫苗血清型 (NVTs). 由于NVT的侵入性和监测偏见,疾病中的血清型替代比运输中少.
科学领域:
- 微生物学 微生物学
- 免疫学 免疫学 免疫学
- 公共卫生 公共卫生
背景情况:
- 七价肺炎球菌联合疫苗 (PCV7) 显著降低了肺炎球菌疾病负担.
- 由于PCV7的血清型覆盖范围有限,人们对非疫苗血清型 (NVTs) 的流行率增加存在担忧.
研究的目的:
- 审查肺炎球菌携带者和PCV7疫苗接种后疾病中血清型替代的证据.
- 解决影响血清型替代发现的监测偏差.
- 讨论NVT携带和疾病患病率之间的差异原因.
主要方法:
- 对肺炎球菌血清型替代现有证据的审查.
- 运输和疾病监测数据的分析.
- 评估数据收集和解释中的潜在偏见.
主要成果:
- 在无症状的载体中,NVT显著增加,整体载体患病率的净变化很小.
- 由NVTs引起的肺炎球菌病在许多人群中增加了,但通常不如NVT携带增加.
- 由于替换血清型和监测偏差的侵入性较低而导致的差异.
结论:
- 疾病中的血清型替代部分可以通过较低的NVT侵入性和监测偏差来解释.
- 持续监测对于监测肺炎球菌疾病中未来的血清型替代趋势至关重要.
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