小児感染免疫第21巻第1号
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1 2009 Vol. 21 No Prevenar , valent pneumococcal conjugate vaccine PCV PCV7 11, invasive pneumococcal infection 2 T B T Disease burden of acute otitis media on children and cost effectiveness of pneumococcal conjugate vaccine in Japan Key words Noboru Yamanaka, Muneki Hotomi Rinya Sugita
2 IgM PCV7 4 6B 9V 14 18C 19F 23F ,15 PCV7 WHO 2007 PCV B 9V 14 18C 19F 23F CRM197 7 Prevenar, Wyeth Lederle Vaccines, Pearl River, NY, USA 4 1 Kaiser Permanente Study , CI CI A 9N 18B 19A 23A 5195 CI CI CI CI ProteinD CI CI 41 69
3 2009 Vol. 21 No CI CI 2 57 PCV PCV7 1 8 Advanced treatment for otitis media study group ATOMS 29 refer to ENT 2nd line ,807 2 PCV7 Ray 12 PCV7 AOM AOM 2 Simple AOM 1st line 3rd line AOM AOM 5 AOM AOM 1 5
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5 2009 Vol. 21 No AOM AOM AOM AOM 1 AOM AOM , , , , PCV7 PCV PCV7 Ray AOM AOM CDC Vaccine Price List ,000
6 st line 50 mg kg 6 5,352 5,502 5,614 2nd line 14 mg kg 6 4,577 5,417 6,177 3rd line 90 mg kg 6 4,051 4,689 5, ,800 13,800 6,900 Intractable mg kg mg kg ,422 60,428 37, mg kg mg kg ,992 61,279 34,820 3 OPAT mg kg 5 10,901 11,933 12,904 3 IPARET 5 40 mg kg mg kg , , ,747 Intractable 60,746 61,392 38, PCV ,724 4,524 7 PCV PCV , PCV
7 2009 Vol. 21 No ,056,800 1,091,316 1,115,649 AOM AOM 695, , , ,456 AOM 1 9,895 70,931 10,349 70, , ,684 9, ,012 AOM 1 42, ,696 42, ,825 AOM , , AOM , ,016 1, ,149, , ,915 8, ,318 35, , ,164, , ,396 9, ,009 35, , ,542 1,808 1,087 3,656 4,743 PCV ,32
8 ,056,800 7, ,056,800 7, ,056,800 7, ,056,800 7, ,056,800 7, AOM Vaccine efficacy Ray GT Vaccine AOM total Vaccine AOM total Vaccine AOM Vaccine AOM AOM AOM Ray AOM AOM AOM AOM Ray 1 2 AOM3 AOM
9 2009 Vol. 21 No PRSP n 34 Total n PRSP n 12 Total n 68 PRSP n 46 Total n rd line AOM 1,809 4,743 3 PCV7 PCV , Kaiser Permanente Study , ,500 g A 9.1 6B F F 14.9 PRSP 19F 23F PCV7 herd effect PCV7 4 PCV7 22,23 6B 9V 14 19A 19F 23F PCV7 PCV7 35,36
10 ,34 PCV PCV ,38 PCV7 PCV7 PCV7 Advanced Treatments for Otitis Media Study Group ATOMS 1 Teele DW, Klein JO, Rosner B Epidemiology of otitis media during the first seven years of life in children in Greater Boston a prospective, cohort study. J Infect Dis , Advisory Committee on Immunization Practices Preventing pneumococcal disease among infants and children Recommendations of the Advisory Committee on Immunization Practices ACIP. MMWR Rep , Finkelscein JA, Merlay JP, Davis RL, et al Antimicrobial use in defined populations of infants and young children. Arch Pediatr Adolesc Med , Brixner DI Improving acute otitis media outcomes through proper antibiotic use and adherence. Am J Manag Care 11 Suppl.S202 S210, Joki Erkkila VP, Laippala P, Pukander J Increase in paediatric acute otitis media diagnosed by pri-
11 2009 Vol. 21 No. 147 mary care in two Finnish municipalities versus Epidemiol Infect , Fried VM, Makuc DM, Rooks RN Ambulatory health care visits by children principal diagnosis and place of visit. Vital Health Stat , Charles J, Pan Y, Britt H Trends in childhood illness and treatment in Australian general practice, MJA , Black S, Shinefield H, Fireman B, et al Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Pediatr Infect Dis J , Whitney CG, Farley MM, Hadler J, et al Decline in invasive pneumococcal disease after the introduction of protein polysaccharide conjugate vaccine. N Engl J Med , Kyaw MH, Lynfield R, Schaffner W, et al Effect of introduction of the pneumococcal conjugate vaccine on drug resistant Streptococcus pneumoniae. N Engl J Med , Lieu TA, Ray GT, Black SB, et al Projected cost effectiveness of pneumococcal conjugate vaccination of healthy infants and young children. JAMA , Ray GT, Whitney CG, Fireman BH, et al Cost effectiveness of pneumococcal conjugate vaccine Evidence from the first 5 years of use in the United States incorporating herd effects. Pediatr Infect Dis J , O Brien KL, Steinhoff MC, Edwards K, et al Immunologic priming of young children by pneumococcal glycoprotein, but not polysaccharide, vaccines. Pediatr Infect Dis J , Hausdorff WP, Bryant J, Paradiso PR, et al Which pneumococcal serogroups cause the most invasive disease implications for conjugate vaccine formulation and use. Part. Clin Infect Dis , Hausdorff WP, Bryant J, Klock C, et al The contribution of specific pneumococcal sergroups to different disease manifestations implications for conjugate vaccine formulation and use. Part. Clin Infect Dis , WHO Weekly Epidemiolo Rec, March 23, Eskola J, Kilpi T, Palmu A, et al Efficacy of a pneumococcal conjugate vaccine against acute otitis media. N Engl J Med , Kilpi T, et al Protective efficacy of a second pneumococcal conjugate vaccine against pneumococcal acute otitis media in infants and children randomized, controlled trial of a 7 valent pneumococcal polysaccharide meningococcal outer membrane protein conjugate vaccine in 1666 children. Clin Infect Dis , Pymula R, et al Pneumococcal capsular polysaccharides conjugated to protein D for prevention of acute otitis media caused by both Streptococcus pneumoniae and non typeable Haemophilus influenzae a randomized double blind efficacy study. Lancet , Gonzales R, Malone DC, Maselli JH, et al Excessive antibiotic use for acute respiratory infections in the United States. Clin Infect Dis , Casey JR, Pichichero ME Changes in frequency and pathogens causing acute otitis media in Pediatr Infect Dis J , Dowel SF, Butler JC, Giebink GC, et al Acute otitis media management and surveillance in an era of pneumococcal resistance a report from the Drug resistant Streptococcus pneumoniae Therapeutic Working Group. Pediatr Infect Dis J , Hotomi M, Yamanaka N, Shimada J, et al Factors associated with clinical outcomes in acute otitis media. Ann Otol Rhinol Laryngol , Hotomi M, Yamanaka N, Samukawa T, et al Treatment and outcome of severe and non severe acute otitis media. Eur J Pediatr ,
12 data kokusei 2005 kihon1 00 zuhyou a00411.xls 31 Niemela M, Uhari M, Jounio Ervasti K, et al Lack of specific symptomatology in children with acute otitis media. Pediatr Infect Dis J , Kontiokari T, Koivunen P, Niemela M, et al Symptoms of acute otitis media. Pediatr Infect Dis J , Black S, Shinefield H Safety and efficacy of the seven valent pneumococcal conjugate vaccine evidence from northern California. Eur J Pediatr 161 Suppl 2S127 S131, Hotomi M, Billal DS, Kamide Y, et al Serotype distribution and penicillin resistance of Streptococcus pneumoniae isolates from middle ear fluids of pediatric patients with acute otitis media in Japan. J Clin Microbiol , Jacobs MR Prevention of otitis media role of pneumococcal conjugate vaccines in reducing incidence and antibiotic resistance. J Pediatr , Fireman B, Black SB, Shinefield HR, et al Impact of the pneumococcal conjugate vaccine on otitis media. Pediatr Infect Dis J , Yano H, Suetake, Kuga A, et al Pulsed field gel electrophoresis analysis of nasopharyngeal flora in children attending a day care center. J Clin Microbiol , Shimada J, Yamanaka N, Hotomi M, et al Household transmission of Streptococcus pneumoniae among siblings with acute otitis media. J Clin Microbiol , 2002
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