A profound study on pneumococcal diseases in children in China
10.3760/cma.j.cn101070-20200302-00304
- VernacularTitle:进一步关注我国儿童肺炎链球菌性疾病的研究
- Author:
Yonghong YANG
1
;
Kunling SHEN
;
Yuejie ZHENG
Author Information
1. 深圳市儿童医院呼吸科，广东 深圳 518000；国家儿童医学中心，首都医科大学附属北京儿童医院呼吸科，国家呼吸系统疾病临床医学研究中心，北京 100045
- From:
Chinese Journal of Applied Clinical Pediatrics
2020;35(7):481-484
- CountryChina
- Language:Chinese
-
Abstract:
Pneumococcal infections can lead to serious invasive diseases such as meningitis, sepsis and pneumonia, as well as milder but more common illnesses like sinusitis and otitis media.The causative agent, Streptococcus pneumoniae, usually colonizes the human nasopharynx and is transmitted mainly through respiratory droplets.Infants and young children are the main reservoir of this organism.Of the estimated 5.83 million deaths among under 5 years old in the world in 2015, 294 000 were caused by pneumococcal infections, and 23 300 were ascribed to coinfection of pneumococcal infections with human immunodeficiency virus.The prevalence and mortality rates of pneumococcal diseases are higher in developing countries than in industrialized countries, and most deaths occur in Africa and Asia.Before widespread introduction of pneumococcal conjugate vaccine(PCV)into national immunization programmes in 2006, the reported mean annual incidence of invasive pneumococcal disease (IPD)in children aged <2 years was 44.4/100 000 per year in Europe and 167/100 000 per year in the United States of America.Pneumococcal diseases caused 700 000 to 1 000 000 deaths in children aged<2 years, accounting for 28% of the vaccine preventable diseases in this age group.The increasing number of pneumococcal isolates resistant to β-lactam and macrolide antibiotics worldwide in recent years makes it more difficult for clinicians to treat this disease.Among excellent studies on pneumococcus and pneumococcal diseases conducted by Chinese pediatricians in the past 30 years, some were multi-center surveillance for the serotyping, antibiotic resistance and molecular typing of clinical isolates, especially of IPD strains.These studies have evaluated the effect of antigen and antibody measurement on diagnosis of pneumococcal diseases, and reviewed lung tissues of autopsy for the children died of pneumonia, verifying that pneumococcus was a potential pathogen.The serotyping, antibiotic resistance and molecular typing of isolates varied in different time periods and areas in China.Severe pneumonia caused by pneumococcus was common recently, and some cases deteriorated into empyema, sepsis and even septic shock.Pneumococcus also leads to hemolytic uremic syndrome in some cases.This issue relates to, such reports from many experts.Currently available PCV are safe and effective.Compared with the first licensed PCV7, the increase in the number of serotypes in these vaccines represents significant progress in the fight against pneumococcal disease-related morbidity and mortality, particularly in developing countries.World Health Organization recommends the inclusion of PCV in childhood immunization programmes worldwide.Since 2008, when PCV7 was introduced in China, Chinese Medical Association and Pneumococcal Awareness Council of Expert (PACE) have held several activities every year on the Pneumonia Day to raise the concerns of pediatricians and parents on pneumonia and pneumococcal diseases in children.Pediatricians pay great attention to the vaccines and immune programmes in the world.The first expert consensus statement on Streptococcus pneumoniae and pneumococcal diseases was formulated by the Group of Respiratory, Chinese Pediatric Society, Chinese Medical Association in 2009.The consensus on laboratory diagnosis regulations of pneumococcal diseases was published in 2012.The issue delivers Chinese experts′ consensus statement on diagnosis, treatment and prevention of pneumococcal diseases in children written by pediatric experts from different specialties.This consensus raises various view of clinicians, hoping to provide reference and help to pediatricians, child health workers and preventive medicine workers.
