Abstract：
Interactions of Streptococcus pneumoniae with viruses feature in the pathogenesis of numerous respiratory illnesses.
We undertook a case-control study among adults at Kaiser Permanente Southern California between 2015 and 2019. Case patients had diagnoses of lower respiratory tract infection (LRTI; including pneumonia or nonpneumonia LRTI diagnoses), with viral infections detected by multiplex polymerase chain reaction testing. Controls without LRTI diagnoses were matched to case patients by demographic and clinical attributes. We measured vaccine effectiveness (VE) for 13-valent (PCV13) against virus-associated LRTI by determining the adjusted odds ratio for PCV13 receipt, comparing case patients and controls.
Primary analyses included 13 856 case patients with virus-associated LRTI and 227 887 matched controls. Receipt of PCV13 was associated with a VE of 24.9% (95% confidence interval, 18.4%-30.9%) against virus-associated pneumonia and 21.5% (10.9%-30.9%) against other (nonpneumonia) virus-associated LRTIs. We estimated VEs of 26.8% (95% confidence interval, 19.9%-33.1%) and 18.6% (9.3%-27.0%) against all virus-associated LRTI episodes diagnosed in inpatient and outpatient settings, respectively. We identified statistically significant protection against LRTI episodes associated with influenza A and B viruses, endemic human coronaviruses, parainfluenza viruses, human metapneumovirus, and enteroviruses but not respiratory syncytial virus or adenoviruses.
Among adults, PCV13 conferred moderate protection against virus-associated LRTI. The impacts of pneumococcal conjugate vaccines may be mediated, in part, by effects on polymicrobial interactions between pneumococci and respiratory viruses.
We undertook a case-control study among adults at Kaiser Permanente Southern California between 2015 and 2019. Case patients had diagnoses of lower respiratory tract infection (LRTI; including pneumonia or nonpneumonia LRTI diagnoses), with viral infections detected by multiplex polymerase chain reaction testing. Controls without LRTI diagnoses were matched to case patients by demographic and clinical attributes. We measured vaccine effectiveness (VE) for 13-valent (PCV13) against virus-associated LRTI by determining the adjusted odds ratio for PCV13 receipt, comparing case patients and controls.
Primary analyses included 13 856 case patients with virus-associated LRTI and 227 887 matched controls. Receipt of PCV13 was associated with a VE of 24.9% (95% confidence interval, 18.4%-30.9%) against virus-associated pneumonia and 21.5% (10.9%-30.9%) against other (nonpneumonia) virus-associated LRTIs. We estimated VEs of 26.8% (95% confidence interval, 19.9%-33.1%) and 18.6% (9.3%-27.0%) against all virus-associated LRTI episodes diagnosed in inpatient and outpatient settings, respectively. We identified statistically significant protection against LRTI episodes associated with influenza A and B viruses, endemic human coronaviruses, parainfluenza viruses, human metapneumovirus, and enteroviruses but not respiratory syncytial virus or adenoviruses.
Among adults, PCV13 conferred moderate protection against virus-associated LRTI. The impacts of pneumococcal conjugate vaccines may be mediated, in part, by effects on polymicrobial interactions between pneumococci and respiratory viruses.
摘要：
肺炎链球菌与病毒的相互作用是许多呼吸系统疾病的发病机理。
我们在2015年至2019年间对南加州KaiserPermanente的成年人进行了一项病例对照研究。病例患者诊断为下呼吸道感染（LRTI；包括肺炎或非肺炎LRTI诊断），通过多重聚合酶链反应测试检测到病毒感染。没有LRTI诊断的对照根据人口统计学和临床特征与病例患者相匹配。我们通过确定PCV13接收的调整比值比，测量了13价（PCV13）对病毒相关LRTI的疫苗有效性（VE），比较病例患者和对照组。主要分析包括13856例病毒相关LRTI患者和227887例匹配对照。PCV13的接收与24.9%的VE相关(95%置信区间，18.4％-30.9％）针对病毒相关性肺炎和21.5％（10.9％-30.9％）针对其他（非肺炎）病毒相关LRTI。我们估计VE为26.8%(95%置信区间，19.9％-33.1％）和18.6％（9.3％-27.0％）针对在住院和门诊环境中诊断出的所有与病毒相关的LRTI发作，分别。我们确定了对与甲型和乙型流感病毒相关的LRTI发作具有统计学意义的保护作用，地方性人类冠状病毒，副流感病毒，人类偏肺病毒，和肠道病毒，但不是呼吸道合胞病毒或腺病毒。
在成年人中，PCV13对病毒相关的LRTI具有中等保护作用。肺炎球菌结合疫苗的影响可能是介导的，在某种程度上,通过对肺炎球菌和呼吸道病毒之间的多微生物相互作用的影响。
我们在2015年至2019年间对南加州KaiserPermanente的成年人进行了一项病例对照研究。
在成年人中，
