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目的了解广州地区老年人感染肺炎球菌的血清型别特征,评估广州地区老年人群接种肺炎疫苗的免疫效果。方法随机抽取2015年11月至2016年10月哨点医院的肺炎球菌感染老年病例为病例组,在病例所在社区随机选取同性别、60岁及以上年龄相近(±3岁)、接种疫苗适应证相似的健康居民作为对照组。采用1∶1配对病例对照研究23价肺炎球菌多糖疫苗(PPV23)的免疫效果。采用多重PCR法进行病例肺炎球菌血清分型。结果共276对病例及对照纳入研究,PPV23疫苗对老年人肺炎的保护效果为77.3%(95%CI 62.8%~91.8%)。检出肺炎球菌血清型主要为19F、19A、6B和23F;PPV23疫苗包含的血清型对其覆盖率达96.6%。结论 PPV23疫苗对老年人肺炎有较好的保护效果,PPV23疫苗包含的血清型别与广州地区老年人群病例菌株检出的血清型别的吻合程度较高,PPV23疫苗适用于广州地区的老年人群。
Objective To understand the serotype characteristics of pneumococcal pneumonia in the elderly in Guangzhou and to evaluate the immune effect of pneumonia vaccination in elderly population in Guangzhou. Methods The elderly patients with pneumococcal infection in the sentinel hospital from November 2015 to October 2016 were randomly selected as the case group. The same sex was selected randomly in the community where the cases were located. The age of 60 years and above was similar (± 3 years old) and the vaccination indication Similar healthy residents as a control group. A 1:1 matched case-control study was conducted to evaluate the immunogenicity of the 23-valent pneumococcal polysaccharide vaccine (PPV23). Multiple PCR method for case pneumococcal serotyping. Results A total of 276 cases and controls were included in the study. The protective effect of PPV23 vaccine on elderly pneumonia was 77.3% (95% CI 62.8% -91.8%). The pneumococcal serotypes were mainly detected as 19F, 19A, 6B and 23F. The serotypes of PPV23 vaccines covered 96.6% of their serotypes. Conclusions PPV23 vaccine has a good protective effect on pneumonia in elderly patients. The serotypes of PPV23 vaccines are consistent with the serotypes of serogroups detected in the elderly population in Guangzhou. The PPV23 vaccine is suitable for elderly population in Guangzhou.