摘要
目的:评估在儿童中侵袭性肺炎球菌病(IPD)的发生情况、临床表现的差异性及其结局。确定肺炎链球菌所引起的侵袭性疾病中链球菌的主要血清学反应和由新出现的球菌结合疫苗所掩盖的潜在性的血清学反应。方法:对诺丁汉两所教学医院在1980年1月至1999年12月期间收住的所有侵袭性肺炎球菌病患儿的记录信息进行前瞻性分析。结果:确认侵袭性肺炎患儿为266例;103例患儿(39%)年龄【1岁。
Aims: To evaluate the incidence, spectrum of clinical manifestations, and outcome of invasive pneumococcal disease (IPD) in children. To determine the major serogroups of Streptococcus pneumoniae responsible for invasive disease and the potential coverage by the new pneumococcal conjugate vaccines. Methods: Analysis of prospectively recorded information of all children admitted to two teacning hospitals in Nottingham with IPD between January 1980 and December 1999. Results: A total of 266 episodes of IPD in children were identified; 103 (9% ) were aged < 1 year and 160 (60% ) < 2 years. Major clinical presentations were meningitis in 86 (32% ), pneumonia in 82 (31%), and bacteraemia without an obvious focus in 80 (30%) . The age specific mean annual incidence rates of IPD overall among children aged < 1, < 2, and < 5 years were 47. 1, 37. 8, and 20 per 100 000 population, respectively. Mortality rates for children with meningitis and non-meningitic infection were 20% and 7% , respectively. Neurological sequelae following meningitis were documented in 16 (26% ) of the 61 survivors assessed. The potential coverage rates in children between the ages of 6 months and 5 years are 84% by the 7 - va-lent, 91% by the 9-valent, and 95% by the 11 - valent conjugate vaccines. Conclusion: This study indicates that inclusion of a pneumococcal conjugate vaccine in the primary immunisation programme in the UK would have a considerable effect on the mortality and morbidity associated with IPD.
