PDF(Pubmed)
Abstract：
Pneumococcal disease is a major cause of morbidity/mortality worldwide, and vaccination is an important measure in its prevention. Despite European children being vaccinated with pneumococcal conjugate vaccines (PCVs), pneumococcal infections are still a major cause of morbidity/mortality in adults with risk conditions and their vaccination might be an important prevention strategy. New PCVs have been approved, but information is lacking on their potential impact in European adults. In our review, we searched PubMed, MEDLINE, and Embase for studies on the additional PCV20 serotypes (concerning incidence, prevalence, disease severity, lethality, and antimicrobial resistance) in European adults, between January 2010 and April 2022, having included 118 articles and data from 33 countries. We found that these serotypes have become more prevalent in both invasive and non-invasive pneumococcal disease (IPD and NIPD), representing a significant proportion of cases (serotypes 8, 12F, 22F) and more serious disease and/or lethality (10A, 11A, 15B, 22F), showing antimicrobial resistance (11A, 15B, 33F), and/or affecting more vulnerable individuals such as the elderly, immunocompromised patients, and those with comorbidities (8, 10A, 11A, 15B, 22F). The relevance of pneumococcal adult carriers (11A, 15B, 22F, and 8) was also identified. Altogether, our data showed an increase in the additional PCV20 serotypes\' prevalence, accounting for a proportion of approximately 60% of all pneumococcal isolates in IPD in European adults since 2018/2019. Data suggest that adults, as older and/or more vulnerable patients, would benefit from vaccination with higher-coverage PCVs, and that PCV20 may address an unmet medical need.
摘要：
肺炎球菌疾病是全球发病率/死亡率的主要原因，疫苗接种是预防的重要措施。尽管欧洲儿童接种了肺炎球菌结合疫苗（PCV），肺炎球菌感染仍然是有风险的成年人发病/死亡的主要原因,其疫苗接种可能是重要的预防策略.新的PCV已经批准，但是缺乏有关其对欧洲成年人的潜在影响的信息。在我们的审查中,我们搜索了PubMed,MEDLINE,和Embase用于其他PCV20血清型的研究(关于发病率，患病率,疾病严重程度,杀伤力,和抗菌素耐药性)在欧洲成年人中，2010年1月至2022年4月，共纳入来自33个国家的118篇文章和数据。我们发现，这些血清型在侵袭性和非侵袭性肺炎球菌疾病（IPD和NIPD）中变得更加普遍，代表显著比例的病例(血清型8，12F，22F）和更严重的疾病和/或致死率（10A，11A,15B,22F),显示耐药性(11A，15B,33F)，和/或影响老年人等更脆弱的个人，免疫力低下的患者，以及有合并症的人(8，10A，11A,15B,22F).肺炎球菌成人携带者的相关性（11A，15B,22F,和8)也被确定。总之,我们的数据显示额外的PCV20血清型患病率增加，自2018/2019年以来，占欧洲成年人IPD中所有肺炎球菌分离株的约60%。数据表明，成年人，作为年龄较大和/或更脆弱的患者，将受益于更高覆盖率的PCV疫苗接种，PCV20可以解决未满足的医疗需求。
