在PCV10引入后,尼泊尔婴儿中非疫苗血型替代和疫苗类型的亚主导持久性
Fleurette Mbuyakala Domai1,2,3, Dhruba Shrestha4, Raj Kumar Shrestha4
1Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan.
Vaccines
|January 28, 2026
概括
10肺炎球菌合疫苗 (PCV10) 减少了尼泊尔婴儿的疫苗类型肺炎球菌携带,但非疫苗血清型 (NVTs) 增加,突出了更广泛的保护策略的需要.
科学领域:
- 儿童传染病 儿童传染病
- 疫苗学 疫苗学 疫苗学
- 微生物学 微生物学
背景情况:
- 肺炎链球菌导致尼泊尔的儿童死亡率显著.
- 已经引入了10价肺炎球菌合疫苗 (PCV10),但其有效性受到非疫苗血清型 (NVTs) 和未检测到的多种血清型携带的挑战.
- 了解PCV10后的血清型分布变化对于公共卫生战略至关重要.
研究的目的:
- 调查尼泊尔婴儿PCV10免疫接种前后肺炎球菌血清型分布的变化.
- 为了在疫苗后的时代识别主导血清型.
- 分析与肺炎球菌携带相关的风险因素.
主要方法:
- 在尼泊尔的Bhaktapur (2020-2022) 进行了一项纵向队列研究.
- 从6周,9个月和12个月的婴儿身上收集了鼻抽样.
- 纳米流体qPCR平台被用于检测多个血清型和量化细菌负载,并使用逆概率权重 (IPW) 进行风险因素分析.
主要成果:
- PCV10显著减少了疫苗类型 (VT) 携带,从32.8%降至4.8%.
- NVTs迅速增加并成为主导型,血清型35B,19A,6C/6D和15B/15C成为最常见的.
- 携带的风险因素包括更年长的婴儿期,家庭厨房的近距离,以及冬季/季风前的季节.
结论:
- PCV10有效地减少了VT肺炎球菌的循环,但为NVTs创造了空间.
- 在亚主导中持续存在的静脉瘤携带存在复发和抗生素耐药性的风险.
- 需要更高价值的疫苗和环境干预措施来持续减少肺炎球菌.
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