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頁籤選單縮合
| 題 名 | 2008~2013年間國內侵襲性肺炎鏈球菌感染症流行情形=Epidemiology of Invasive Pneumococcal Disease in Taiwan, 2008~2013 |
|---|---|
| 作 者 | 許家瑜; 王恩慈; 周玉民; 顏哲傑; | 書刊名 | 疫情報導 |
| 卷 期 | 30:22 2014.11.25[民103.11.25] |
| 頁 次 | 頁451-463 |
| 分類號 | 412.41 |
| 關鍵詞 | 侵襲性肺炎鏈球菌感染症; 結合型肺炎鏈球菌疫苗; 肺炎鏈球菌多醣體疫苗; 再次感染; Invasive pneumococcal disease; Pneumococcal polysaccharide vaccine; Pneumococcal conjunctive vaccine; Recurrent; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 我國自 2007 年10月起逐步推行75歲以上老人肺炎鏈球菌多醣體疫苗接種,隨後在 2009年7 月起,5歲以下高危險孩童亦開始結合型肺炎鏈球菌疫苗接種計畫,本文欲瞭解 2008-2013年間國內侵襲性肺炎鏈球菌感染症(Invasive pneumococcal disease,IPD)之發生率與致死率、個案潛在疾病及臨床症狀、再次感染情形及血清型變化等,並進一步討論目前防疫現況。 這六年法定傳染疾病監測資料中,共計4439例確定個案,平均年發生率為每10萬人口3.2人,其中2-4歲幼兒之發生率為最高(每10萬人口為20.4人)。平均致死率為18.2%,其中75歲以上的老人致死率為35.5%。 個案中具有潛在疾病者佔 35.9%,以罹患惡性腫瘤者最為常見(12.7%);在臨床感染症狀的表現上,以出現肺炎的病患為最多(61.0%)。此外,再次感染 IPD個案有 39位(0.9%),年齡中位數為 58歲,其中 72%有潛在疾病,30%重複感染相同的血清型別。 IPD菌株血清型別在未滿 5歲者以19A為首(佔比為 39.5%),65歲以上則以14、23F及 3為主(三者總佔比為 48.8%),值得注意的是 2012-2013年間血清型 15(不包含 15B)檢出率增加,此型別不涵括在目前已上市的任何肺炎鏈球菌疫苗裡。以 2013年為例,未滿 5歲個案之菌株血清型別在 7價結合型肺炎鏈球菌疫苗(PCV7)與 13價結合型肺炎鏈球菌疫苗(PCV13)涵蓋率分別為21.4%與79.5%,10價結合型肺炎鏈球菌疫苗(PCV10)與PCV7疫苗血清型別涵蓋率一致。此外,未滿5歲個案之PCV7/PCV10疫苗型別發生率,自2008年的每10萬人口11.06人降到2013年的2.54人,而PCV13疫苗型別的發生率則由14.53人降到9.44人,非 PCV13涵蓋型別的發生率則由0.77人增加至1.73人。 隨著疫苗政策推行,國內IPD流行情形亦隨之變化,為評估肺炎鏈球菌疫苗成效並適時修訂防治政策,現階段仍應持續監視國內 IPD發生情形及肺炎鏈球菌血清型別與抗藥性變化,方能降低IPD對國人健康的危害。 |
| 英文摘要 | The pneumococcal polysaccharide vaccine(PPV)vaccination programfor elderly has implemented in Taiwansince October 2007, followed by pneumococcal conjunctive vaccine(PCV)vaccination programfor high-risk children <5 years old, beginning from July 2009. In this study,the domestic invasive pneumococcal disease(IPD)incidence, case-fatality rate, clinical syndromes, underlying disease cases, recurrent IPD and change of serotypesbetween 2008-2013are illustrated, and the current strategies ofIPD controlarefurther discussed. There were 4,439 identified IPD cases during these six years.Overall annual incidence was 3.2 cases per millionpopulations, and thehighest incidence was in 2-4 years age group (20.4 per million population). The average case fatality rate(CFR) was 18.2%, andthe CFR of cases in ≧75 years age group was 35.5%. Cases withunderlying disease accounted for 35.9%, and the most common disease was malignancy (12.7%). Pneumonia was the most commonclinical symptoms (61.0%) in IPD cases, followed by sepsis (47.9%). About 20% of the cases were complicated by pneumonia and sepsis. In addition, there were39 recurrent IPD cases (0.9%), with median age of 58 years, of which 72% had underlying disease, and 30%were re-infected by pneumococcus with the same serotypes. 19A was the most prevalent serotype in IPD cases< 5 years old(accounting for 39.5%).Dominantserotypes in≧65 years age groups were 14,23F and 3 (totally accounted for 48.8%). It is worth noting that there have been significant increases in the rate of serotype 15 (15B was not included) since2012/2013, and serotype 15was not covered by any PCVs. In 2013, for example, coverage ratesof 7-valent conjugated pneumococcal vaccine (PCV7) and 13-valent conjugated pneumococcal vaccine (PCV13) were 21.4% and 79.5% in < 5 years age group.Coverage rate of 10-valent conjugated pneumococcal vaccine (PCV10) was consistent with that of PCV7 in < 5 years age group. In addition, the incidence of serotypes covered by PCV7/PCV10 in < 5 years age group declined from 11.06 per 100,000 persons in 2008 to 2.54 in 2013. The incidence of PCV13 serotypes dropped from 14.53 to 9.44,but non-PCV13 serotypes increased from 0.77 to 1.73. To protectpeople from IPD,surveillance of domestic IPD epidemiology and changes of serotypes and antimicrobial resistance in Streptococcus pneumoniaeshould be continued for assessing the effectiveness of pneumococcal vaccines and revising the prevention policies timely. |
本系統中英文摘要資訊取自各篇刊載內容。