7价肺炎球菌多糖结合疫苗对全球肺炎球菌疾病的影响  

Impact of 7-valent Pneumococcal Conjugate Vaccine to Global Pneumococcal Disease

作　　者：裴迎新[1] 曾光[1] 

机构地区：[1]中国疾病预防控制中心现场流行病学培训项目,北京100050

出　　处：《中国疫苗和免疫》2014年第5期465-472,共8页Chinese Journal of Vaccines and Immunization

摘　　要：肺炎球菌疾病是全球的严重公共健康问题之一,据世界卫生组织2008年估算,全球约有47.6万例〈5岁儿童死于肺炎球菌疾病。目前临床治疗过程中,抗生素治疗是首选。但随着抗生素的广泛使用,肺炎球菌耐药日趋严峻,因此,采用疫苗预防的必要性日益凸显。2000年全球首个可用于〈2岁儿童的7价肺炎球菌多糖结合疫苗（7-valent Pneumococcal Polysaccharide Conjugate Vaccine,PPCV7）在美国获批使用。现就PPCV7应用10多年来对全球肺炎球菌疾病的影响进行综述。结果表明,及早主动接种PPCV7进行预防,可有效降低侵袭性肺炎球菌疾病、社区获得性肺炎和中耳炎等的发病率和死亡率。同时,PPCV7可覆盖大部分耐药肺炎球菌的感染,其保护作用在婴儿期基础免疫后至少可持续2-3年,甚至更长。在流行性感冒（流感）大流行时期,PPCV7显著降低流感相关肺炎的住院率,且PPCV7在免疫缺陷等高危人群中效果显著。另外,当PPCV7接种率达到一定水平,其保护效果表现出更广泛的群体免疫效应,使全人群获益。Invasive pneumococcal disease is a serious global public health problem.Based on an estimate by the World Health Organization in 2008,about 476 000 children 5 years died due to invasive pneumococcal disease.Currently for clinical treatment,antibiotics are the first choice.But with widespread use of antibiotics,antibiotic resistance of streptococcus pneumonia has increased to become a serious problem.Therefore,the necessity of vaccination is becoming more and more important.In 2000,the first7-valent pneumococcal conjugate vaccine（ PPCV7） was licensed in the USA and used for 2 years children to prevent invasive pneumococcal disease.This article summarizes the impact of PPCV7 which has been used for more than a decade for global pneumococcal disease prevention.Our review shows that active vaccination with PPCV7 as early as possible can effectively reduce morbidity and mortality of invasive pneumococcal disease,pneumococcal pneumonia,and otitis media.At the same time,PPCV7 can prevent most infections due to antibiotic-resistant pneumococcal bacteria.Its protective effect can remain for at least 2- 3 years or longer.During influenza pandemics,PPCV7 can significantly reduce flu-related pneumococcal pneumonia hospitalization rates,and has a remarkable effect in high-risk groups such as the immunodeficient population.In addition,when the vaccination coverage rate with PPCV7 reaches a certain level,its protective effect will show herd immunity,and will benefit the entire population,including those not targeted for vaccination.

关 键 词：7价肺炎球菌多糖结合疫苗 肺炎球菌 侵袭性肺炎球菌疾病 

分 类 号：R186[医药卫生—流行病学] R378.14[医药卫生—公共卫生与预防医学]