在高度接种疫苗的人群中获得社区性肺炎球菌性肺炎:按血清型,疫苗接种状态和潜在医疗条件进行分析
Hakjun Hyun1,2,3, A-Yeung Jang1, Jin Woong Suh4
1Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
尽管疫苗接种率很高,但肺炎球菌血清型分布在韩国正在演变. 血清型3和19A仍然是肺炎球菌社区获得性肺炎 (pCAP) 的常见原因,但23性肺炎球菌多糖体疫苗 (PPSV23) 可能会降低PCAP死亡率.
科学领域:
- 传染性疾病 传染性疾病
- 流行病学 流行病学
- 疫苗学 疫苗学 疫苗学
背景情况:
- 韩国对肺炎球菌病的疫苗接种率很高.
- 肺炎球菌血清型分布的不断变化对疫苗有效性提出了挑战.
- 了解当前的血清型患病率对于公共卫生战略至关重要.
研究的目的:
- 调查社区获得性肺炎 (CAP) 患者的人口和临床特征.
- 为了确定CAP患者肺炎球菌血清型分布.
- 确定肺炎球菌CAP (pCAP) 中30天死亡率的风险因素,并评估疫苗接种的影响.
主要方法:
- 韩国五所大学医院 (2018年9月至2021年7月) 对CAP患者 (≥19岁) 的前性队列研究.
- 对人口统计数据,临床特征,肺炎球菌血清型分布和30天死亡风险因素的分析.
- 由于3pCAP血清型的高流行率,对3pCAP血清型进行了具体分析.
主要成果:
- 肺炎链球菌是CAP的主要原因 (11.8%).
- 血清型3是最常见的 (10.0%),其次是19A,34和35B.
- 高龄,长期护理机构住院和细菌病是死亡的风险因素;23-valent肺炎球菌多糖体疫苗 (PPSV23) 接种与死亡风险降低有关.
结论:
- 血清型3和19A在韩国pCAP病例中仍然普遍存在,尽管存在免疫计划.
- 接种PPSV23疫苗可能会降低pCAP患者的死亡风险.
- 对肺炎球菌血清型的持续监测对于有效的疾病控制至关重要.
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