论文标题
降低与俄罗斯流感无关的呼吸道死亡率：引入肺炎球菌疫苗接种（PCV13）的影响，还是护理的改善？
Reduction in respiratory mortality not associated with influenza in Russia: effect of the introduction of pneumococcal vaccination (PCV13), or improvement in care?
论文作者
论文摘要
背景。 2014年引入了俄罗斯儿童（以及老年人）的肺炎球菌疫苗接种（PCV13），没有事先使用PCV7。尽管在接下来的几年中，儿童和成人的肺炎住院率均未降低，但呼吸道死亡率确实会随着时间而下降。此外，抗生素之间存在很强的关联，包括俄罗斯儿童肺炎链球菌的多药耐药性和PCV13疫苗血清型，以及近年来俄罗斯败血症患者中肺炎链球菌的存在非常低。流感循环的年度差异可能会影响呼吸死亡率的某些变化。方法。我们从最近对俄罗斯流感相关死亡率的研究中应用了推断方法，将每月的呼吸道死亡率在09/2010至08/2019之间关联到流感循环的每月指数和与流感无关的死亡率的每月指数，从而允许2015年开始基线率的潜在趋势。从2014/15季节开始（每个季节从9月到八月），与流感无关的呼吸道死亡率的基线率降低，而2018/19年度的基准呼吸道死亡率每100,000个人的呼吸道死亡率降低12.41（95％CI（10.6,14.2））与2010- 2010-2014期间相比。结论。尽管护理的改善可能导致呼吸道死亡率降低与俄罗斯流感无关的速度，但上述时间一致的减少与PCV13引入后肺炎链球菌的传播和运输中疫苗血清型的传播和运输在肺炎链球菌的传播和运输中的逐渐兼容。需要进一步的工作来更好地了解PCV13对俄罗斯呼吸道感染和相关死亡率的流行病学的影响。
Background. Pneumococcal vaccination (PCV13) for children (as well as older adults) in Russia was introduced in 2014, with no prior PCV7 use. While pneumonia hospitalization rates, both in children and adults did not decrease in the following years, respiratory mortality rates did decline with time. Moreover, there is a strong association between antibiotic, including multidrug resistance and PCV13 vaccine serotypes for S. pneumoniae in children in Russia, and presence of S. pneumoniae among sepsis cases in Russia during the recent years has been very low. Annual variability in influenza circulation may affect some of the changes in respiratory mortality rates. Methods. We applied the inference method from our recent study of influenza-associated mortality in Russia to relate monthly respiratory mortality rates between 09/2010 and 08/2019 to monthly indices of influenza circulation and baseline rates of mortality not associated with influenza, allowing for a potential trend in the baseline rates starting 2015. Results. Baseline rates of respiratory mortality not associated with influenza decreased with time starting from the 2014/15 season (with each season running from September to August), with the 2018/19 baseline rates of respiratory mortality per 100,000 individuals being lower by 12.41 (95% CI (10.6,14.2)) compared to the 2010-2014 period. Conclusions. While improvement in care might have contributed to the reduction in the rates of respiratory mortality not associated with influenza in Russia, the above temporally consistent reduction is compatible with the gradual replacement of vaccine serotypes in the transmission and carriage of S. pneumoniae following the introduction of PCV13. Further work is needed to better understand the impact of PCV13 on the epidemiology of respiratory infections and related mortality in Russia.
