阿根廷儿科肺炎球菌脑膜炎的发展情况 (2013-2023)
Jonathan Zintgraff1, Paula Gagetti2, Nahuel Sanchez Eluchans1
1Servicio Bacteriología Clínica, Departamento de Bacteriología, Instituto Nacional de Enfermedades Infecciosas (INEI)-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires C1282AFF, Argentina.
阿根廷的肺炎球菌合疫苗 (PCV) 减少了特定的血清型,但增加了其他类型,需要持续的疫苗接种策略. 抗菌素耐药性仍然是一个问题,在耐药菌株中出现非PCV13血清型.
科学领域:
- 公共卫生 公共卫生
- 儿童传染病 儿童传染病
- 微生物学 微生物学
- 流行病学 流行病学
背景情况:
- 肺炎球菌结合疫苗 (PCV) 于2012年在阿根廷的国家免疫计划中实施.
- 肺炎球菌脑膜炎仍然是一个重大的公共卫生问题,特别是在儿童群体中.
- 了解疫苗接种后的血清型分布和抗菌素耐药性的变化对于公共卫生政策至关重要.
研究的目的:
- 评估PCV对肺炎球菌脑膜炎病例,血清型分布和阿根廷儿童抗菌耐药性的影响 (2013-2023年).
- 为了比较早期 (2013-2014) 和晚期 (2022-2023) 的PCV后期.
- 确定血清型流行率和抗菌素耐药性概况的趋势.
主要方法:
- 对2013年至2023年期间收集的333个肺炎球菌分离物的分析.
- 标准肺炎球菌血型鉴定用于在6岁以下的儿童中识别感染血型.
- 亚格拉稀释方法用于确定抗微生物耐药性概况.
主要成果:
- 血清型1,5和14显著下降;血清型10A,15B/C和24B显著增加.
- 在2022-2023年,顶级血清型包括血清组24 (21.4%),10A (10.7%) 和15B/C (10.7%).
- 37%的分离物显示不对青素敏感;2.9%的Cefotaxime. 25%是多药耐药 (MDR),非PCV13血清型 (例如24F,24A,24B) 在MDR分离物中普遍存在.
结论:
- 在阿根廷,PCV的实施导致了肺炎球菌血清型流行病学的重大转变.
- 抗菌素耐药性,特别是非PCV13血清型,仍然是一个关键的挑战.
- 持续扩大疫苗政策,包括考虑增强间接保护的疫苗,对于持续的公共卫生效益至关重要.
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