Pneumococcal infection requires urgent attention and vaccination is the most effective method

Pneumococcal infection requires urgent attention and vaccination is the most effective method

Winter and spring are the periods of high incidence of respiratory diseases. Reporters recently learned at a science popularization event related to pneumococcal disease that pneumococci (also known as “Streptococcus pneumoniae”), as a common infectious pathogen, are also the number one cause of bacterial community-acquired pneumonia. The World Health Organization (WHO) estimates that there are approximately 1.6 million deaths caused by pneumococci every year worldwide, most of which are infants and the elderly. The elderly and patients with chronic diseases are susceptible to pneumococcal infection. Experts recommend that the above-mentioned people receive pneumococcal vaccine in time, and combined with influenza vaccine for better protection.

What is pneumococcal bacteria? Huang Yi, chief physician and professor of the Department of Respiratory and Critical Care Medicine at Changhai Hospital, said that pneumococci are opportunistic pathogens that often “lurk” in the human nasopharynx and do not usually cause disease. However, when the body’s immunity declines, respiratory viral infections such as influenza occur, malnutrition, or the elderly and infirm, pneumococci will take advantage of the situation.

Diseases caused by pneumococcal infection can be divided into invasive pneumococcal disease (IPD) and non-invasive pneumococcal disease (NIPD).

Although small pneumococci are not very pathogenic, once infected, they can cause IPD and related complications, which can be very harmful. Huang Yi said that unlike viruses such as influenza and COVID-19 that can be transmitted through droplets or even air, pneumococcal diseases have no evidence of human-to-human transmission. They do not fall into the category of infectious diseases and do not need to be reported. Therefore, there is a lack of definite pneumococcal pneumonia in our country. epidemiological data.

However, a large number of epidemiological surveys at home and abroad show that pneumococci are the most common among community-acquired pneumonia caused by bacteria. A recent national multi-center prospective study in China showed that pneumococcal bacteria are the second leading cause of severe community-acquired pneumonia in adults in China after influenza virus, accounting for nearly 20%, ranking first among all bacteria, and causing nosocomial deaths. The mortality rate of pneumococcal meningitis is 12.8%; in developing countries, the mortality rate of pneumococcal meningitis is as high as 50%.

Once infected with pneumococcal bacteria, the probability of illness in the elderly is significantly increased. Research shows that taking invasive pneumococcal disease (IPD) as an example, data from the Asia-Pacific region shows that the risk of IPD increases with age. The incidence rate in elderly people aged 65 to 79 years is twice that of healthy adults aged 50 to 64 years old; American studies have also confirmed that the incidence of hospitalization for community-acquired pneumonia in elderly patients increases with age. The hospitalization rate for pneumonia among people aged 65-74 is about twice that of people aged 60-64; chronic lung disease, chronic heart disease People with chronic diseases such as vascular disease and diabetes are 6 times, 6 times and 3 times more likely to develop IPD than healthy people, respectively.

Not only is the incidence of pneumonia high in the elderly, but the seriousness rate and mortality rate are also high. The mortality rate of pneumonia in the elderly is related to the presence of complications and the severity of the disease. The 30-day mortality rate is about 0.8% among elderly patients with mild symptoms who do not require hospitalization, while it is as high as 33.0%, nearly one-third, among severe patients. , so there is a saying in the industry that “pneumonia is the killer of the elderly.”

In clinical treatment of pneumococcal diseases, antibacterial treatment is the first priority. However, as the resistance rate of pneumococci to commonly used antibacterial drugs such as penicillin and erythromycin increases year by year, the difficulty of treatment has also increased. How to prevent problems before they occur and reduce infections? As early as 2008, the World Health Organization (WHO) listed pneumococcal diseases as a disease that requires the use of vaccines as a “very high priority”.

The Chinese Society of Preventive Medicine also recommends that the 23-valent pneumococcal vaccine (PPSV23) be used for vaccination of people aged 50 and above and patients with chronic diseases such as diabetes, cardiovascular disease, and lung disease. Experts are clear that pneumococcal vaccination is the most effective way to prevent pneumococcal infection.

The reporter learned that since September 2013, Shanghai has taken the lead in mainland my country to provide free vaccination of one dose of the domestically produced 23-valent pneumococcal polysaccharide vaccine (PPSV23) to the elderly aged 60 and above with local household registration. Currently, there are five PPSV23 models on the market in mainland my country for adult use, including one imported and four domestically produced.

In response to the question raised by some citizens, “Do seniors who have been vaccinated against pneumococcal vaccine for five years still need to be boosted?” Experts said that seniors over 60 years old can get a booster shot five years after vaccination (booster immunity is not required) Free again); for young people, one injection of pneumococcal vaccine is enough.

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