在成年人中通过血清型3侵袭性肺炎球菌病的演变:西班牙三十年的回顾性研究
Sara Calvo-Silveria1,2, Aida González-Díaz1,2, Inmaculada Grau2,3
1Microbiology Department, Hospital Universitari de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain.
The Lancet regional health. Europe
|May 13, 2024
概括
由于3型血清型 (S3-IPD) 的侵入性肺炎球菌病在成年人中保持稳定,尽管引入了PCV13疫苗. 发生了克隆转移,死亡率下降,并增加了相关疾病,表明临床管理和人口健康的发展.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 基因组学就是基因组学.
背景情况:
- 由3型血清型 (S3-IPD) 引起的侵入性肺炎球菌病与高死亡率有关.
- 在儿童中使用的13肺炎球菌合疫苗 (PCV13) 并没有减少西班牙成人S3-IPD发病率.
- 了解成人S3-IPD流行病学和基因组学至关重要.
研究的目的:
- 分析西班牙成人S3-IPD的发病率,临床特征和基因组学.
- 评估PCV13引入对S3-IPD趋势的影响.
- 为了比较不同S3-IPD系的特征.
主要方法:
- 在巴塞罗那一家医院 (1994-2020年) 收集成人IPD病例的前景.
- 来自六家西班牙医院 (2008-2020年) 的S3-IPD分离物和历史分离物 (1989-1993年) 的全基因组测序 (WGS).
- 发生率,临床数据和基因组资料在PCV13前后期间和基因系之间进行比较.
主要成果:
- 成年S3-IPD发病率从PCV前期到PCV13后期保持相对稳定 (1.58到1.28每10万人年).
- 观察到主导系的转变:CC180-GPSC12增加,而CC260-GPSC83减少.
- 整体30天死亡率下降 (32.4%至16.7%),但并发病率增加 (77.3%至85.7%).
- 在两个主要的S3系之间没有发现显著的临床差异或死亡率变化.
- CC180-GPSC12谱系显示出更高的遗传多样性,更开放的泛基因组,更多的prophages和耐药基因.
结论:
- 在西班牙,成人S3-IPD发病率在很大程度上不受儿童PCV13疫苗接种的影响,但发生了克隆替代.
- 减少S3-IPD死亡率表明改善了临床管理或人口健康变化.
- 在疾病严重程度上S3囊的作用被基因上不同的血统之间缺乏临床差异所强调.
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