Tetracyclines

四环素
  • 文章类型: Journal Article
    幼小的农场动物容易受到机会性感染,这可能会由于死亡率和体重增加不良而造成经济损失。抗微生物药物耐药性的发展以及提高治疗效果和安全性的愿望是寻求新的抗菌药物以确保快速恢复且不良事件最少的原因。
    评估DOKSIAVZ500在幼猪呼吸道病变中的功效。
    该研究是在65-70天大的约克郡仔猪中进行的,这些仔猪有细菌呼吸道病变的迹象。用试验药物处理动物3或5天。参考组接受了TETRAMAX500,其化学结构与测试药物相似,作用机制,和活动谱。使用临床检查评估动物的状态,临床血细胞计数,和细菌学测试。
    测试药物和参考药物均具有良好的耐受性,并确保动物在约4天内恢复。恢复伴随着血液学参数和菌群组成的正常化。与疾病发展有关的细菌,猪链球菌,几乎在所有组中完全被淘汰。没有注意到不良事件。治疗后,所有的动物都很容易增加体重和市场质量。
    DOKSIAVZ500是一种高效的疗法,用于治疗由仔猪中的常驻机会菌群引起的呼吸道疾病。它也显示出非劣性与TETRAMAX500在所有与健康相关的参数方面,因此可以推荐用于养猪场的兽医实践。
    UNASSIGNED: Young farm animals are susceptible to opportunistic infections which may cause economic losses due to mortality and poor weight gain. The development of antimicrobial resistance and the desire to improve therapy efficacy and safety are the reasons to seek for new antibacterial drugs ensuring rapid recovery with minimum adverse events.
    UNASSIGNED: To estimate the efficacy of DOKSI AVZ 500 in respiratory pathologies in young pigs.
    UNASSIGNED: The study was conducted in 65-70-day-old Yorkshire piglets with signs of bacterial respiratory pathologies. The animals were treated with the test drug for 3 or 5 days. The reference group received TETRAMAX 500 which is similar to the test drug in terms of chemical structure, mechanism of action, and activity spectrum. The animal\'s status was assessed using clinical examination, clinical blood count, and bacteriological tests.
    UNASSIGNED: Both test and reference drugs were well tolerated and ensured the animal recovery within about 4 days. The recovery was accompanied by normalization of hematological parameters and flora composition. The bacterium associated with the disease development, Streptococcus suis, was virtually completely eliminated in all groups. No adverse events were noted. After the treatment, all the animals readily gained weight and live market quality.
    UNASSIGNED: DOKSI AVZ 500 was a highly efficient therapy for respiratory pathologies caused by the resident opportunistic flora in piglets. It has also shown noninferiority vs. TETRAMAX 500 in terms of all the health-related parameters and thus can be recommended for introduction in veterinary practice in pig farms.
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  • 文章类型: Journal Article
    生物炭,一种来自热解生物质的可持续吸附剂,因其在抗生素固相萃取(SPE)中的功效而受到关注,特别关注四环素(TC)。尽管它具有公认的潜力,在基于生物炭的SPE系统中操作的复杂分离机制尚未完全破译。这项研究将小球藻生物炭与商业竹生物炭进行了对比,利用一系列分析方法-微观结构表征,吸附热力学,竞争吸附动力学,H+反滴定,和选择性吸附研究-辅以Box-Behnken设计,以优化小球藻/竹子-SPE,并随后将其应用于动物源性食品的分析。这项研究揭示了一种混合吸附剂,以95/5的质量比将氮掺杂的微孔小球藻生物炭与介孔竹生物炭集成,显著减少不可逆吸附,同时增强选择性,超越单一生物炭SPE系统的性能。阐明的分离机制暗示了一个分区模型,小球藻生物炭上的富氧官能团和竹子生物炭的快速吸附动力学,所有这些都是由混合生物炭框架内的静电相互作用协调的。此外,混合生物炭-SPE与高效液相色谱(HPLC)的协同作用证明了在动物内脏中检测TC的非凡熟练程度,回收率从80.80%到106.98%,RSD从0.24%到14.69%。实质上,这项研究不仅揭示了影响SPE效率的多方面因素,而且推动了生物炭在环境监测和食品安全保障方面的应用。
    Biochar, a sustainable sorbent derived from pyrolyzed biomass, has garnered attention for its efficacy in solid-phase extraction (SPE) of antibiotics, with a particular focus on tetracyclines (TCs). Despite its recognized potential, the intricate separation mechanisms operative in biochar-based SPE systems have not been fully deciphered. This investigation contrasts chlorella biochar against commercial bamboo biochar, harnessing an array of analytical methodologies-microstructure characterization, adsorption thermodynamics, competitive adsorption kinetics, H+ back titration, and selectivity adsorption studies-complemented by a Box-Behnken design for the optimization of chlorella/bamboo-SPE and subsequent application in the analysis of animal-derived foodstuffs. The study unveils that a hybrid sorbent, integrating nitrogen-doped microporous chlorella biochar with mesoporous bamboo biochar in a 95/5 mass ratio, markedly diminishes irreversible adsorption while enhancing selectivity, surpassing the performance of single biochar SPE systems. The elucidated separation mechanisms implicate a partition model, propelled by oxygen-rich functional groups on chlorella biochar and the rapid adsorption kinetics of bamboo biochar, all orchestrated by electrostatic interactions within the mixed biochar framework. Moreover, the synergy of mixed biochar-SPE with high-performance liquid chromatography (HPLC) demonstrates exceptional proficiency in detecting TCs in animal viscera, evidenced by recovery rates spanning 80.80 % to 106.98 % and RSDs ranging from 0.24 % to 14.69 %. In essence, this research not only sheds light on the multifaceted factors influencing SPE efficiency but also propels the use of biochar towards new horizons in environmental monitoring and food safety assurance.
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  • 文章类型: Journal Article
    美国抗生素市场失灵已经威胁到未来的创新和供应。了解临床医生何时以及为何未充分利用最近批准的革兰氏阴性抗生素可能有助于在未来的抗生素开发和潜在的市场进入奖励中优先考虑患者。
    为了确定最近美国食品和药物管理局(FDA)批准的革兰氏阴性抗生素(头孢他啶-阿维巴坦,头孢洛赞-他唑巴坦,美罗培南-瓦巴坦,plazomicin,eravacycline,亚胺培南-来巴坦-西司他丁,和头孢地洛),并确定与它们的优先使用相关的因素(相对于传统的仿制药)在革兰氏阴性感染患者中表现出难以治疗的耐药性(DTR;也就是说,对所有一线抗生素的耐药性)。
    回顾性队列。
    619家美国医院。
    成人住院患者。
    使用加权线性回归计算抗生素使用的季度百分比变化。机器学习选择的候选变量,和混合模型确定了与新(vs.传统)抗生素在DTR感染中的使用。
    在2016年第1季度至2021年第2季度之间,头孢特洛扎-他唑巴坦(2014年批准)和头孢他啶-阿维巴坦(2015年)主导了新的抗生素使用,而随后批准的革兰氏阴性抗生素的吸收相对缓慢。在革兰氏阴性感染住院患者中,0.7%(2551[2631发作],共362142次)显示DTR病原体。在2631例DTR发作中,有1091例患者仅使用传统药物治疗(41.5%),包括“储备”抗生素,如多粘菌素,氨基糖苷类,和替加环素在1091例发作中的865例(79.3%)。有菌血症和慢性疾病的患者有更大的调整概率和那些没有复苏状态的患者,急性肝功能衰竭,和鲍曼不动杆菌复合体和其他非假性非发酵罐病原体接受更新的调整概率较低(与传统的)用于DTR感染的抗生素,分别。新抗生素药敏试验的可用性增加了使用的可能性。
    残余混杂。
    尽管FDA在2014年至2019年之间批准了7种下一代革兰氏阴性抗生素,但临床医生仍经常使用老年人治疗耐药革兰氏阴性感染,安全性-疗效欠佳的通用抗生素。未来抗生素具有针对未开发病原体生态位的创新机制,广泛可用的敏感性测试,证明耐药感染结局改善的证据可能会提高利用率。
    美国食品和药物管理局;NIH校内研究计划。
    UNASSIGNED: The U.S. antibiotic market failure has threatened future innovation and supply. Understanding when and why clinicians underutilize recently approved gram-negative antibiotics might help prioritize the patient in future antibiotic development and potential market entry rewards.
    UNASSIGNED: To determine use patterns of recently U.S. Food and Drug Administration (FDA)-approved gram-negative antibiotics (ceftazidime-avibactam, ceftolozane-tazobactam, meropenem-vaborbactam, plazomicin, eravacycline, imipenem-relebactam-cilastatin, and cefiderocol) and identify factors associated with their preferential use (over traditional generic agents) in patients with gram-negative infections due to pathogens displaying difficult-to-treat resistance (DTR; that is, resistance to all first-line antibiotics).
    UNASSIGNED: Retrospective cohort.
    UNASSIGNED: 619 U.S. hospitals.
    UNASSIGNED: Adult inpatients.
    UNASSIGNED: Quarterly percentage change in antibiotic use was calculated using weighted linear regression. Machine learning selected candidate variables, and mixed models identified factors associated with new (vs. traditional) antibiotic use in DTR infections.
    UNASSIGNED: Between quarter 1 of 2016 and quarter 2 of 2021, ceftolozane-tazobactam (approved 2014) and ceftazidime-avibactam (2015) predominated new antibiotic usage whereas subsequently approved gram-negative antibiotics saw relatively sluggish uptake. Among gram-negative infection hospitalizations, 0.7% (2551 [2631 episodes] of 362 142) displayed DTR pathogens. Patients were treated exclusively using traditional agents in 1091 of 2631 DTR episodes (41.5%), including \"reserve\" antibiotics such as polymyxins, aminoglycosides, and tigecycline in 865 of 1091 episodes (79.3%). Patients with bacteremia and chronic diseases had greater adjusted probabilities and those with do-not-resuscitate status, acute liver failure, and Acinetobacter baumannii complex and other nonpseudomonal nonfermenter pathogens had lower adjusted probabilities of receiving newer (vs. traditional) antibiotics for DTR infections, respectively. Availability of susceptibility testing for new antibiotics increased probability of usage.
    UNASSIGNED: Residual confounding.
    UNASSIGNED: Despite FDA approval of 7 next-generation gram-negative antibiotics between 2014 and 2019, clinicians still frequently treat resistant gram-negative infections with older, generic antibiotics with suboptimal safety-efficacy profiles. Future antibiotics with innovative mechanisms targeting untapped pathogen niches, widely available susceptibility testing, and evidence demonstrating improved outcomes in resistant infections might enhance utilization.
    UNASSIGNED: U.S. Food and Drug Administration; NIH Intramural Research Program.
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  • 文章类型: Journal Article
    目标:埃拉瓦环素,一种新的四环素衍生物,表现出广谱抗微生物敏感性。本研究旨在全面考察埃拉环素的体外活性,替加环素,和厄他培南对抗各种革兰氏阳性,革兰氏阴性,和厌氧细菌。
    方法:使用肉汤微量稀释法测定最小抑制浓度(MIC)。收集了以下细菌物种:万古霉素敏感(VS)肠球菌物种,耐万古霉素肠球菌(VRE),金黄色葡萄球菌,硬化链球菌,拟杆菌属物种,艰难梭菌,无菌梭菌,产气荚膜梭菌,双分支杆菌,和嗜麦芽窄食单胞菌.
    结果:我们发现,与替加环素和厄他培南相比,埃拉环素表现出优异的体外活性。值得注意的是,它显示了几种细菌的最低MIC90,包括VS粪肠球菌(0.12μg/mL),VS屎肠球菌(0.12μg/mL),和其他人。此外,VRE对埃拉环素(MIC90:0.12μg/mL)和替加环素(MIC90:0.12μg/mL)敏感,但均对厄他培南耐药(MIC90>64μg/mL)。金黄色葡萄球菌也对埃拉环素(MIC90:0.5μg/mL)以及替加环素(MIC90:1.0μg/mL)敏感。此外,对埃拉环素(MIC90:2.0μg/mL)和替加环素(MIC90:4.0μg/mL)的敏感性更高,但低于厄他培南(MIC90:32.0μg/mL)。伊拉伐环素和替加环素也表现出对厌氧菌的良好敏感性,包括拟杆菌属物种(敏感率:100%),P.Distasonis(100%),艰难C.(94.1-100%),C.无毒(94.1-96.1%),产气荚膜梭菌(88.9-96.3%)。对于嗜麦芽嗜血杆菌,替加环素和埃拉环素的MIC90均为2μg/mL.在埃拉环素和替加环素对各种细菌物种的MIC值之间注意到中等到强的相关性(rho=0.608-0.804,P<0.001)。
    结论:我们的研究强调了埃拉环素作为多药耐药细菌感染的有效治疗选择的潜力。
    OBJECTIVE: Eravacycline, a new tetracycline derivative, exhibits broad-spectrum antimicrobial susceptibility. This study aimed to comprehensively investigate in vitro activities of eravacycline, tigecycline, and ertapenem against various Gram-positive, Gram-negative, and anaerobic bacteria.
    METHODS: Minimum inhibitory concentrations (MICs) were determined using the broth microdilution method. The following bacterial species were collected: vancomycin-sensitive (VS) Enterococci species, vancomycin-resistant Enterococci species (VRE), Staphylococcus aureus, Streptococcus anginosus, Bacteroides species, Clostridioides difficile, Clostridium innocuum, Clostridium perfringens, Parabacteroides distasonis, and Stenotrophomonas maltophilia.
    RESULTS: We found that eravacycline exhibited superior in vitro activity compared to tigecycline and ertapenem. Notably, it exhibited the lowest MIC90 for several bacterial species, including VS E. faecalis (0.12 µg/mL), VS E. faecium (0.12 µg/mL), and others. Besides, VRE was susceptible to eravacycline (MIC90:0.12 µg/mL) and tigecycline (MIC90:0.12 µg/mL), but was all resistant to ertapenem (MIC90 > 64 µg/mL). S. aureus was also susceptible to eravacycline (MIC90:0.5 µg/mL) as well as tigecycline (MIC90:1.0 µg/mL). Furthermore, S. anginosus showed higher susceptibility to eravacycline (MIC90:2.0 µg/mL) and tigecycline (MIC90:4.0 µg/mL), but lower to ertapenem (MIC90:32.0 µg/mL). Eravacycline and tigecycline also demonstrated good susceptibility to anaerobes, including Bacteroides species (susceptibility rate: 100%), P. distasonis (100%), C. difficile (94.1‒100%), C. innocuum (94.1‒96.1%), and C. perfringens (88.9‒96.3%). For S. maltophilia, both tigecycline and eravacycline showed an MIC90 of 2 µg/mL. A moderate-to-strong correlation (rho = 0.608-0.804, P < 0.001) was noted between the MIC values of eravacycline and tigecycline against various bacterial species.
    CONCLUSIONS: Our study highlights the potential of eravacycline as an effective treatment option for multidrug-resistant bacterial infections.
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  • 文章类型: Journal Article
    由于金属暴露,细菌中抗生素耐药性的同时发展对环境和人类健康构成了重大威胁。这项研究探讨了暴露于砷和抗生素如何影响亚砷酸盐氧化剂的能力,木氧化无色杆菌CAW4,转化亚砷酸盐及其抗生素抗性模式。该细菌是从孟加拉国昌德布尔地区砷污染的地下水中分离出来的。我们确定了亚砷酸盐的最小抑制浓度(MIC),头孢噻肟,和四环素用于木氧喜散杆菌CAW4,表现出多药耐药(MDR)特征。在这个决定之后,我们的目的是模拟一种环境,在该环境中,木氧氧化A.CAW4暴露于亚砷酸盐和抗生素.我们使菌株能够在亚MIC浓度的1mM亚砷酸盐中生长,40µg/mL头孢噻肟,和20微克/毫升四环素。分析了在存在或不存在抗生素的情况下亚砷酸盐氧化酶(aioA)基因的表达动力学。研究结果表明,同时接触亚砷酸盐和抗生素会对细菌代谢砷的能力产生不利影响。然而,当亚砷酸盐存在于含抗生素的培养基中时,它促进了细菌的生长。该研究观察到aioA基因在砷抗生素条件下的全球下调,表明通过环境中整个细菌群体的共抗性增加易感性的可能性。这项研究解释了细菌的砷代谢能力可以拯救细菌免受抗生素应激,进一步传播环境交叉抗性。因此,细菌中金属驱动的抗生素耐药性的共同选择凸显了需要采取有效措施来应对这种对人类健康和环境的新威胁。
    The simultaneous development of antibiotic resistance in bacteria due to metal exposure poses a significant threat to the environment and human health. This study explored how exposure to both arsenic and antibiotics affects the ability of an arsenite oxidizer, Achromobacter xylosoxidans CAW4, to transform arsenite and its antibiotic resistance patterns. The bacterium was isolated from arsenic-contaminated groundwater in the Chandpur district of Bangladesh. We determined the minimum inhibitory concentration (MIC) of arsenite, cefotaxime, and tetracycline for A. xylosoxidans CAW4, demonstrating a multidrug resistance (MDR) trait. Following this determination, we aimed to mimic an environment where A. xylosoxidans CAW4 was exposed to both arsenite and antibiotics. We enabled the strain to grow in sub-MIC concentrations of 1 mM arsenite, 40 µg/mL cefotaxime, and 20 µg/mL tetracycline. The expression dynamics of the arsenite oxidase (aioA) gene in the presence or absence of antibiotics were analyzed. The findings indicated that simultaneous exposure to arsenite and antibiotics adversely affected the bacteria\'s capacity to metabolize arsenic. However, when arsenite was present in antibiotics-containing media, it promoted bacterial growth. The study observed a global downregulation of the aioA gene in arsenic-antibiotic conditions, indicating the possibility of increased susceptibility through co-resistance across the entire bacterial population of the environment. This study interprets that bacterial arsenic-metabolizing ability can rescue the bacteria from antibiotic stress, further disseminating environmental cross-resistance. Therefore, the co-selection of metal-driven antibiotic resistance in bacteria highlights the need for effective measures to address this emerging threat to human health and the environment.
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  • 文章类型: Journal Article
    背景:患者报告的结果(PRO)正在成为寻常痤疮(AV)疾病影响评估的基本组成部分,补充临床医生报告的结果。在现实世界中,使用sarecycline的AV患者的PRO上没有数据。
    方法:单臂,纳入9岁被诊断为中度或重度非结节性房室综合征的患者的前瞻性队列研究作为临床实践中常规护理的一部分(N=30).患者接受口服sareccine(60毫克,100毫克,或150毫克)持续12周,作为日常护理的一部分。主要终点是12周时患者(12岁)和护理人员(9-11岁患者)的痤疮症状和影响量表(ASIS)反应以及相对于基线的变化(CFB)。研究者’sAV严重程度和不良事件(AE)的全球评估(IGA)也被记录。
    结果:共有253名房室综合征患者完成了研究(成人:60.1%,女性:77.6%)。在第12周,ASIS平均得分显着下降(P&lt;.0001):体征(平均CFB&plusmn;标准偏差[SD]:&ndash;0.8&plusmn;0.7),影响(–1.0±1.0),情绪影响(–1.2±1.1),和社会影响(0.6±1.1)。患者和护理人员报告AV严重程度(P&lt;.0001)显着降低。IGA成功率为58.9%,医师对治疗结果的满意度为88.1%。在研究期间,共有31名(10.3%)患者报告了≥1不良事件。
    结论:接受口服抗生素治疗12周的中度至重度房室综合征患者的房室综合征相关症状和社会心理负担显著改善。J药物Dermatol.2024;23:1(增刊1):s12-18。
    BACKGROUND: Patient-reported outcomes (PROs) are emerging as a fundamental component of disease impact assessment in acne vulgaris (AV), complementing clinician-reported outcomes. No data is available on PROs for patients with AV using sarecycline in real-world settings.
    METHODS: A single-arm, prospective cohort study that included patients ≥9 years old diagnosed with moderate or severe non-nodular AV was implemented as part of routine care in clinical practices (N=30). Patients received oral sarecycline (60 mg, 100 mg, or 150 mg) for 12 weeks, as part of usual care. The primary endpoint was Acne Symptom and Impact Scale (ASIS) responses from patients (≥12 years) and caregivers (for patients 9-11 years) at week 12 and change from baseline (CFB). Investigator’s Global Assessment (IGA) of AV severity and adverse events (AEs) were also recorded.
    RESULTS: A total of 253 patients with AV completed the study (adults: 60.1%, females: 77.6%). ASIS mean scores significantly decreased (P <.0001) at week 12 for: signs (mean CFB ± standard deviation [SD]: –0.8 ± 0.7), impact (–1.0 ± 1.0), emotional impact (–1.2 ± 1.1), and social impact (0.6 ± 1.1). Significant reductions in AV severity (P <.0001) were reported by patients and caregivers. The IGA success rate was 58.9% and physician satisfaction with treatment outcomes was 88.1%. A total of 31 (10.3%) patients reported ≥1 AE during the study.
    CONCLUSIONS: Patients with moderate-to-severe AV receiving acne management with an oral antibiotic for 12 weeks experienced a significant improvement in AV-related symptoms and psychosocial burden. J Drugs Dermatol. 2024;23:1(Suppl 1):s12-18.
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  • 文章类型: Journal Article
    背景:需要简明的患者报告结果(PRO)工具,以解决面部寻常痤疮(AV)对患者的影响。功能和日常生活活动(ADL)。
    方法:12周,单臂,前瞻性队列研究是在≥9岁的患者中进行的,这些患者患有中度/重度非结节性面部房室,作为常规护理的一部分。主要终点包括用专家小组问卷评估的房室特定患者和护理人员报告的结果(EPQ,由10位专家使用Delphi方法开发)在患者(12岁)和护理人员(患者9-11岁)中。其他评估包括父母/照顾者对儿童的看法。
    结果:共有253名患者完成了研究。经过12周的治疗,有显著的(P&le;.0001)变化从基线患者的比例,他们从来没有或很少:感到愤怒(31.6%),担心AV恶化(28.9%),对AV有想法(20.9%),对AV有一定程度的担忧(38.7%),改变了他们的社交媒体/自拍活动(23.7%),由于AV(22.9%),对现实生活中的计划产生了影响,努力隐藏AV(21.3%),由于AV(15.0%),感觉被选中/判断,由于AV(13.8%),他们担心他们实现未来目标的能力,或因房室感染而影响睡眠(18.2%)。父母/看护人对儿童AV问题的理解与基线相比没有显著变化,从患者和父母/护理人员的角度来看。
    结论:在12周的房室治疗中,通过EPQ测量,患者报告对情绪/社会功能和ADL的AV相关影响显着降低,一个简单的PRO在临床实践中使用的潜力。J药物Dermatol.2024;23:1(增刊1):s4-11。
    BACKGROUND: Concise patient-reported outcome (PRO) instruments addressing the consequences of facial acne vulgaris (AV) on patients’ functioning and activities of daily living (ADL) are needed.
    METHODS: A 12-week, single-arm, prospective cohort study was conducted in patients ≥9 years old with moderate/severe non-nodular facial AV prescribed sarecycline as part of usual care. The primary endpoint included AV-specific patient- and caregiver-reported outcomes assessed with the expert panel questionnaire (EPQ, developed by 10 experts using a Delphi method) in patients (>12 years) and caregivers (for patients 9-11 years). Additional assessments included parental/caregiver perspectives on children’s AV.
    RESULTS: A total of 253 patients completed the study. Following 12-weeks of treatment, there were significant (P ≤.0001) changes from baseline in the proportion of patients responding that they never or rarely: felt angry (31.6%), worried about AV worsening (28.9%), had thoughts about AV (20.9%), had a certain level of worries about AV (38.7%), altered their social media/selfie activity (23.7%), had an impact on real-life plans due to AV (22.9%), made efforts to hide AV (21.3%), felt picked-on/judged due to AV (15.0%), were concerned about their ability to reach future goals due to AV (13.8%), or had sleep impacted due to AV (18.2%). No significant change from baseline was observed for parent/caregiver’s understanding of the child’s AV concerns, from both patient and parent/caregiver perspectives.
    CONCLUSIONS: Over 12 weeks of AV management with oral sarecycline, patients reported significant reductions in AV-related effects on emotional/social functioning and ADL as measured by the EPQ, a simple PRO with potential for use in clinical practice. J Drugs Dermatol. 2024;23:1(Suppl 1):s4-11.
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  • 文章类型: Journal Article
    背景:证据表明,接受过初始启动剂量的全细胞百日咳(wP)疫苗的儿童,而不是无细胞百日咳(aP)疫苗,发生IgE介导的食物过敏的风险较低,儿童过敏反应相关的医院介绍的最常见原因。
    目的:评估婴儿期wP与aP疫苗接种与随后住院的过敏反应之间的关系。
    方法:本研究在PMID:34874968下预先注册。新南威尔士州(NSW)出生的儿童(1997-1999年)在4个月大之前接受第一剂含百日咳疫苗的围产期记录与医院和免疫记录有概率联系。调整后的Cox模型用于估计过敏反应编码的住院治疗的风险比(aHRs)和95%置信区间(CIs)。
    结果:有218,093名新南威尔士州出生的儿童在4个月大之前接受了第一剂wP或aP。在这些孩子中,86例患者在5至15岁期间至少因食物引起的过敏反应住院(每个患者的事件范围:1至3)。首次接种wP(wP-1儿童)和首次接种aP(aP-1儿童)的儿童的随访时间为1,476,969年和665,519年,分别。在wP-1儿童和aP-1儿童中,首次因食物过敏反应住院的发生率分别为每100,000儿童年3.5(95%CI2.6-4.6)和5.1(95%CI3.5-7.1)(wP-1儿童的aHR与aP0.47;95%0.26-0.83)。首次接受毒液过敏反应时,wP-1儿童的发病率为每100,000儿童中的4.9(95%CI3.9-6.2),aP-1儿童中的每100,000儿童中的5.1(95%CI3.5-7.1)(wP的aHR与aP0.92;95%0.53-1.60),wP-1儿童和aP-1儿童中每100,000儿童年全因过敏反应10.6例(95%CI9.0-12.4)和aP-1儿童中每100,000儿童年全因过敏反应12.8例(95%CI10.2-15.8)(wP的aHR与aP0.92;95%CI0.53-1.60)结论:婴儿期接种wP疫苗与食物诱导的儿童过敏性反应(因此发生严重住院风险
    BACKGROUND: Evidence suggests that children who had received an initial priming dose of whole-cell pertussis (wP) vaccine, rather than acellular pertussis (aP) vaccine, had a lower risk of developing IgE-mediated food allergy, the most common cause of anaphylaxis-related hospital presentations of childhood.
    OBJECTIVE: To assess the association between wP versus aP vaccination in infancy and subsequent hospital presentations for anaphylaxis.
    METHODS: This study was preregistered under PMID 34874968. Perinatal records for a cohort of New South Wales-born children (1997-1999) receiving their first dose of pertussis-containing vaccine before age 4 months were probabilistically linked to hospital and immunization records. We used adjusted Cox models to estimate hazard ratios (aHRs) and 95% CIs for anaphylaxis-coded hospitalizations.
    RESULTS: There were 218,093 New South Wales-born children who received a first dose of wP or aP before age 4 months. Among these children, 86 experienced at least one hospitalization for food-induced anaphylaxis at age 5-15 years (range of events per patient, one to three). The person-time of follow-up was 1,476,969 years, and 665,519 years for children vaccinated with wP as a first dose (wP-1 children) and aP as a first dose (aP-1 children), respectively. The incidence rates for first hospitalization for food anaphylaxis were 3.5 (95% CI, 2.6-4.6) and 5.1 (95% CI, 3.5-7.1) per 100,000 child-years among wP-1 children and aP-1 children, respectively (aHR for wP vs aP = 0.47; 95% CI, 0.26-0.83). For first admission for venom anaphylaxis, the incidence rate was 4.9 (95% CI, 3.9-6.2) per 100,000 child-years among wP-1 children and 5.1 (95% CI, 3.5-7.1) per 100,000 child-years among aP-1 children (aHR for wP vs aP = 0.92; 95% CI, 0.53-1.60), and for all-cause anaphylaxis, the incidence rate was 10.6 (95% CI, 9.0-12.4) per 100,000 child-years among wP-1 children and 12.8 (95% CI, 10.2-15.8) per 100,000 child-years among aP-1 children (aHR for wP vs aP = 0.92; 95% CI, 0.53-1.60).
    CONCLUSIONS: Vaccination with wP in infancy was associated with a lower risk of hospitalizations for food-induced anaphylaxis (and therefore severe IgE-mediated food allergy) occurring in childhood.
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