目的:评估肺炎球菌结合疫苗(PCV)对急性鼻-鼻窦炎(OC-ARS)眼眶并发症的影响。
方法:对2002-2019年期间所有OC-ARS患儿进行的回顾性队列研究。数据包括临床,人口统计学,实验室,和微生物学发现。将患者分为三组:在引入PCV7之前(第1组),在PCV7之后和PCV13之前(第2组),和PCV13后(第3组)。
结果:在265名入选患者中,117、39和109被分配到第1、2和3组。在学习期间,Chandler分类严重程度1级患者的百分比显著下降,而3级患者的百分比则增加(P=0.011).OC-ARS的年发病率从2002年的12.64例/10万下降到2008年的5.56例/10万,2019年的2.99例/10万(P<0.001)。0-4岁的患者从2002年的每100,000人中的29例急剧下降到2019年的每100,000人中的4.27例(P<0.001)。从所有培养物中回收的病原体是肺炎链球菌(32.5%),不可分型流感嗜血杆菌(27.5%),链球菌种类,(12.5%),金黄色葡萄球菌(20%),在研究期间分布没有变化。28例(10.6%)患者进行了手术。
结论:OC-ARS的总发病率显著下降,主要归因于0-4岁患者的减少。在引入PCV后,记录到疾病的严重程度增加。
OBJECTIVE: To evaluate the impact of the pneumococcal conjugate vaccines (PCVs) introduction on the orbital complications of acute rhino-sinusitis (OC-ARS).
METHODS: A retrospective cohort study of all pediatric patients with OC-ARS during the period 2002-2019. Data included clinical, demographic, laboratory, and microbiology findings. Patients were divided into three groups: before PCV7 introduction (group 1), after PCV7 and before PCV13 (group 2), and after PCV13 (group 3).
RESULTS: Of 265 enrolled patients, 117, 39, and 109 were assigned to groups 1, 2, and 3. During the study period, a significant decrease was recorded in the percentages of patients in Chandler classification severity category 1, with an increase in patients in category 3 (P = 0.011). The yearly incidence of OC-ARS decreased from 12.64 cases per 100,000 population in 2002 to 5.56 per 100,000 in 2008, and 2.99 per 100,000 in 2019 (P < 0.001). Patients aged 0-4 years showed a dramatic decrease from 29 cases per 100,000 population in 2002 to 4.27 per 100,000 in 2019 (P < 0.001). The pathogens retrieved from all cultures performed were Streptococcus pneumoniae (32.5%), non-typeable Haemophilus influenzae (27.5%), Streptococcus Species, (12.5%), and Staphylococcus aureus (20%), with no changes in distribution during the study periods. Surgery was performed in 28 (10.6%) patients.
CONCLUSIONS: A significant decrease was seen in the overall incidence of OC-ARS, mainly attributable to the decrease in patients aged 0-4 years. An increase was recorded in the severity of the disease following PCVs introduction.