社区获得性肺泡肺炎(CAAP)被认为是一种细菌性疾病,主要是肺炎球菌.在全球范围内引入7价和13价肺炎球菌结合疫苗(PCV)后,CAAP发生率显着下降。相比之下,非CAAP下呼吸道感染(NA-LRIs)通常不被认为是肺炎球菌疾病。我们评估了CAAP,NA-LRI,以及PCV实施前后在以色列南部儿科急诊室的胸部X光片(CXR)检查率的总体就诊。
这是一个持续的,前瞻性观察性研究。我们的医院为大约75,000名5岁以下的儿童提供服务,启用发生率计算。PCV7和PCV13分别于2009年7月和2010年11月在以色列实施。根据世界卫生组织解释标准化对所有CXR进行分析。我们计算了CAAP,NA-LRI,和CXR检查2004年至2017年的年度发病率以及PCV13(2014-2017)与PCV前(2004-2008)期间的发病率比.
总的来说,记录了72746例CXR检查:14%CAAP和86%NA-LRI。CAAP,NA-LRI,CXR检查访问率下降了49%,34%,37%,分别。这种模式见于犹太儿童和贝都因儿童(两个种族不同的人群),在犹太儿童和12个月以上的儿童中观察到更陡的下降。
PCV7/PCV13的实施导致幼儿CAAP和CXR检查率的总体就诊率明显下降。总的来说,每年每100000名年龄<5岁的人口中,大约有14750名患者接受了CXR患者的住院治疗。这些结果表明,尽管NA-LRIs通常不被认为是肺炎球菌,许多可以防止PCV。肺炎球菌结合疫苗(PCV7/PCV13)的实施导致幼儿社区获得性肺泡肺炎(CAAP)和整体胸部X线检查率显着下降。尽管非CAAP下呼吸道感染通常不被认为是肺炎球菌,许多可以防止PCV。
Community-acquired alveolar pneumonia (CAAP) is considered a bacterial disease, mainly pneumococcal. CAAP rates markedly declined following 7- and 13-valent pneumococcal conjugate vaccine (PCV) introductions worldwide. In contrast, non-CAAP lower respiratory tract infections (NA-LRIs) are generally not considered pneumococcal diseases. We assessed CAAP, NA-LRIs, and overall visits with chest radiograph (CXR) examination rates in the pediatric emergency room in southern Israel before and after PCV implementation.
This was an ongoing, prospective observational study. Our hospital serves a captive population of approximately 75 000 children aged <5 years, enabling incidence calculation. PCV7 and PCV13 were implemented in Israel in July 2009 and November 2010, respectively. All CXRs were analyzed according to the World Health Organization Standardization of Interpretation. We calculated CAAP, NA-LRI, and CXR examinations annual incidences from 2004 to 2017 and incidence rate ratios comparing the PCV13 (2014-2017) with the pre-PCV (2004-2008) periods.
Overall, 72 746 CXR examinations were recorded: 14% CAAP and 86% NA-LRI. CAAP, NA-LRI, and CXR examination visit rates declined by 49%, 34%, and 37%, respectively. This pattern was seen in Jewish and Bedouin children (the 2 ethnically distinct populations), with steeper declines observed among Jewish children and children aged >12 months.
PCV7/PCV13 implementation resulted in a marked decline in CAAP and overall visits with CXR examination rates in young children. Overall, approximately 14 750 hospital visits with CXR were prevented annually per 100 000 population aged <5 years. These findings suggest that although NA-LRIs are usually not considered pneumococcal, many can be prevented by PCVs.Pneumococcal conjugate vaccine (PCV7/PCV13) implementation resulted in significant declines in community-acquired alveolar pneumonia (CAAP) and overall chest radiography examination rates in young children. Although non-CAAP lower respiratory tract infections are usually not considered pneumococcal, many can be prevented by PCVs.