- 作者: Ching-Fen Shen, Shih-Min Wang, Hsin Chi, Yi-Chuan Huang, Li-Min Huang, Yhu-Chering Huang, Hsiao-Chuan Lin, Yu-Huai Ho, Chao A. Hsiung and Ching-Chuan Liu
- 作者服務機構: 1. Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li Road, North Dist, Tainan, 70403, Taiwan 2. Taiwan Pediatric Infectious Disease Alliance, Taipei City, Taiwan 3. Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan 4. Department of Pediatrics, Mackay Children’s Hospital, Mackay Medical College, Taipei City, Taiwan 5. Division of Infectious Diseases, Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan 6. Department of Pediatrics, National Taiwan University and Hospital, Taipei City, Taiwan 7. Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan 8. College of Medicine, China Medical University, Taichung City, Taiwan 9. Division of Pediatric Infectious Diseases, China Medical University Children’s Hospital, Taichung City, Taiwan 10. Division of Infectious Disease, Department of Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan 11. Institute of Population Health Sciences, National Health Research Institutes, Zhunan Township, Taiwan 12. Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li Road, North Dist, Tainan, 70403, Taiwan 13. Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan City, Taiwan
- 中文摘要:
- 英文摘要:
Background
Pneumococcal conjugate vaccine (PCV) reduces both invasive pneumococcal disease (IPD) and other pneumococcal infections worldwide. We investigated the impact of stepwise implementation of childhood PCV programs on the prevalence of pneumococcal pneumonia, severity of acute inflammation, and associations between breakthrough pneumonia and pneumococcal serotypes in Taiwan.
Methods
In total, 983 children diagnosed with community-acquired pneumococcal pneumonia were enrolled between January 2010 and December 2015.
Results
Proportions of pneumococcal vaccinations increased each year in age-stratified groups with PCV7 (32.2%) as the majority, followed by PCV13 (12.2%). The proportion of pneumococcal pneumonia decreased each year in age-stratified groups, especially in 2–5 year group. Serotype 19A is the leading serotype either in vaccinated (6.4%) or unvaccinated patients (5.2%). In particular, vaccinated patients had significantly higher lowest WBC, lower neutrophils, lower lymphocytes and lower CRP values than non-vaccinated patients (p < 0.05). After stratifying patients by breakthrough infection, those with breakthrough pneumococcal infection with vaccine coverage serotypes had more severe pneumonia disease (p < 0.05).
Conclusion
Systematic childhood pneumococcal vaccination reduced the prevalence of community-acquired pneumococcal pneumonia, especially in 2–5 year group. Serotype 19A was the major serotype for all vaccine types in patients with pneumococcal pneumonia and severity of acute inflammatory response was reduced in vaccinated patients. - 中文關鍵字:
- 英文關鍵字: Community-acquired pneumonia, Epidemiology, Pediatric, Pneumococcal conjugate vaccine, Pneumococcal pneumonia, Serotype