日本后藤市18岁及以上成人社区获得性肺炎发病率

Taiga Miyazaki MD, PhD , Katsuji Hirano MD , Kiyoshi Ichihara MD, PhD , Elisa Gonzalez MS , Bradford D. Gessner MD , Raul E. Isturiz MD , Pingping Zhang MS , Sharon Gray MS , Michael Pride PhD , Mark van der Linden PhD , Luis Jodar PhD , Takahiro Maeda MD, PhD , Shigeru Kohno MD, PhD , Adriano Arguedas MD , Goto City Pneumococcal Pneumonia Incidence Study Group
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引用次数: 0

摘要

背景:2014年日本将23价肺炎球菌多糖疫苗引入≥65岁成人国家免疫规划后,很少有研究测量社区获得性肺炎(CAP)和肺炎球菌疫苗型CAP的负担。在这项研究中,我们估计了2015年至2020年日本成年人中CAP和肺炎链球菌CAP的发病率。研究问题:日本成人CAP和肺炎链球菌CAP的发病率是多少?肺炎链球菌CAP患者常见的肺炎球菌血清型有哪些?研究设计和方法本前瞻性人群为基础的多中心主动监测研究招募了日本后藤市年龄≥18岁的临床和放射学证实的CAP患者。使用标准护理血液和痰培养、BinaxNOW(雅培)和血清型特异性尿抗原检测检测肺炎链球菌。结果共纳入2103例CAP患者;84%的患者年龄≥65岁,6.7%的患者在研究期间死亡。每年的CAP、S肺炎球菌CAP、13价肺炎球菌结合疫苗(PCV13)血清型CAP和20价肺炎球菌结合疫苗(PCV20)血清型CAP发病率分别为每10万人1,280、227、63和110。采用各种检测方法,17.8%的CAP患者检出肺炎链球菌,其中4.9%、5.5%和8.6%的CAP病例来自PCV13、15价肺炎球菌结合疫苗和PCV20血清型。将Goto的发病率和病死率应用于日本人口,假设PCV20具有与PCV13相同的疫苗效力和保护持续时间,并且如果PCV20在日本获得预防CAP的许可,那么将PCV20纳入65岁以上成年人的国家免疫规划,每年可预防29,036例CAP病例和2,275例CAP相关死亡。考虑到可预防肺炎球菌疾病的巨大负担,在日本成年人中引入肺炎球菌结合疫苗可能是有益的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Community-Acquired Pneumonia Incidence in Adults Aged 18 Years and Older in Goto City, Japan

Background

Few studies have measured the burden of community-acquired pneumonia (CAP) and pneumococcal vaccine-type CAP in Japan after the introduction of the 23-valent pneumococcal polysaccharide vaccine into the adult national immunization program for individuals aged ≥ 65 years in 2014. In this study, we estimated the incidences of CAP and Streptococcus pneumoniae CAP among Japanese adults between 2015 and 2020.

Research Question

What are the incidences of CAP and S pneumoniae CAP among Japanese adults? What are the common pneumococcal serotypes detected in patients with S pneumoniae CAP?

Study Design and Methods

This prospective population-based multicenter active surveillance study enrolled adults ≥ 18 years of age with clinically and radiologically confirmed CAP in Goto City, Japan. S pneumoniae was detected using standard-of-care blood and sputum cultures, BinaxNOW (Abbott), and serotype-specific urinary antigen detection assays.

Results

A total of 2,103 patients with CAP were enrolled; 84% were aged ≥ 65 years and 6.7% died during the study. The annual CAP, S pneumoniae CAP, 13-valent pneumococcal conjugate vaccine (PCV13) serotype CAP, and 20-valent pneumococcal conjugate vaccine (PCV20) serotype CAP incidences per 100,000 population were 1,280, 227, 63, and 110, respectively. S pneumoniae was detected in 17.8% of all patients with CAP by any detection method, with 4.9%, 5.5%, and 8.6% of cases of CAP resulting from PCV13, 15-valent pneumococcal conjugate vaccine, and PCV20 serotypes, respectively. Applying Goto’s incidence and case fatality rate to the Japanese population, assuming PCV20 has the same vaccine efficacy and duration of protection as PCV13 and if licensed in Japan for the prevention of CAP, the inclusion of PCV20 in the national immunization program for adults ≥ 65 years of age could prevent 29,036 cases of CAP and 2,275 CAP-related deaths per year.

Interpretation

Given the substantial burden of preventable pneumococcal disease, introduction of pneumococcal conjugate vaccines in Japanese adults may be of merit.

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