肺炎球菌血清型的演变和负担在欧洲成年人在过去十年:一个系统的审查
Rita Teixeira1, Vasiliki Kossyvaki2, Paulina Galvez3
1Vaccines and Antivirals Department, Pfizer Portugal, 1300-477 Lisbon, Portugal.
Microorganisms
|June 28, 2023
概括
肺炎球菌联合疫苗 (PCV) 对于预防肺炎球菌疾病至关重要. 新的PCV20血清型在欧洲成年人中越来越普遍,导致严重的疾病和耐药性,突出显示需要更新的疫苗接种策略.
科学领域:
- 传染性疾病 传染性疾病
- 疫苗学 疫苗学 疫苗学
- 公共卫生 公共卫生
背景情况:
- 肺炎球菌病仍然是全球健康的重大负担,导致大量的发病率和死亡率.
- 虽然在欧洲使用肺炎球菌合疫苗 (PCV) 进行儿童疫苗接种是常见的,但成年人,特别是那些有风险因素的人,仍然很容易受到伤害.
- 需要对PCV20等新型PCV的新兴数据来评估它们对成年人群的影响.
研究的目的:
- 审查与PCV20中额外的血清型相关的流行率,发病率,疾病严重程度,致死率和抗菌素耐药性.
- 评估这些血清型对欧洲成年人侵入性肺炎球菌病 (IPD) 和非侵入性肺炎球菌病 (NIPD) 的影响.
- 确定PCV20等更高覆盖率PCV对成年人疫苗接种策略的潜在益处.
主要方法:
- 使用PubMed,MEDLINE和Embase数据库进行了系统的文献审查.
- 包括在2010年1月至2022年4月期间发表的专注于欧洲成年人的研究.
- 分析了来自33个国家的118篇文章的数据,检查了血清型患病率,疾病特征和抗菌素耐药性.
主要成果:
- 额外的PCV20血清型在欧洲成年人中增加了IPD和NIPD的流行率.
- 特定的血清型 (例如8,12F,22F) 是疾病负担的重要贡献者,而其他类型 (例如10A,11A,15B,22F) 与严重程度和致死率的增加有关.
- 对11A,15B和33F血清型的抗菌素耐药性得到了注意. 血清型8,10A,11A,15B和22F不成比例地影响弱势群体.
- 自2018/2019年以来,这些额外的血清型约占成年IPD中所有肺炎球菌分离物的60%.
结论:
- 在欧洲成年人中增加PCV20血清型的流行率和影响日益增加,这凸显了大量未满足的医疗需求.
- 建议成年人,特别是老年人和患有并发症或免疫功能低下的人,接种包括PCV20在内的更高覆盖率的PCV.
- 更新的疫苗接种策略对于减轻脆弱成年人群中肺炎球菌病的负担至关重要.
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