medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-495medsovet-9608Research ArticleАЛЛЕРГОЛОГИЯ И ИММУНОЛОГИЯALLERGOLOGY AND IMMUNOLOGYИзменения в частоте носительства Streptococcus pneumoniae и в структуре его серотипового состава у организованных детей дошкольного возраста на фоне вакцинации против пневмококковой инфекцииChanges in S. pneumoniae carriage rates and its serotype composition structure in the institutionalized preschool children due to pneumococcal vaccinationhttps://orcid.org/0000-0002-5281-1564ГиринаА. А.GirinaA. A.

Гирина Асия Ахмедовна, к.м.н., доцент, доцент кафедры фармакологии, педиатрии и инфекционных болезней

628011, Ханты-Мансийск, ул. Мира, д. 40

Asiya А. Girina, Cand. Sci. (Med.), Associate Professor, Associate Professor of the Department of Pharmacology, Pediatrics and Infectious Diseases

40, Mirа St., Khanty-Mansiysk, 628011

doctor_okb@mail.ruhttps://orcid.org/0009-0003-1992-3622ТомрачеваЛ. В.TomrachevaL. V.

Томрачева Людмила Витальевна, старший преподаватель кафедры фармакологии, педиатрии и инфекционных болезней

628011, Ханты-Мансийск, ул. Мира, д. 40

Lyudmila V. Tomracheva, Senior Lecturer of the Department of Pharmacology, Pediatrics and Infectious Diseases

40, Mirа St., Khanty-Mansiysk, 628011

Ltomracheva@bk.ruhttps://orcid.org/0000-0003-1303-8318ЗаплатниковА. Л.ZaplatnikovA. L.

Заплатников Андрей Леонидович, д.м.н., профессор, заведующий кафедрой неонатологии имени профессора В.В. Гаврюшова, профессор кафедры педиатрии имени академика Г.Н. Сперанского

123995, Москва, ул. Баррикадная, д. 2/1, стр. 1

Andrey L. Zaplatnikov, Dr. Sci. (Med.), Professor, Head of Department of Neonatology named after Professor V.V. Gavryushov, Professor of Department of Paediatrics named after Academician G.N. Speransky

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

zaplatnikov@mail.ruhttps://orcid.org/0009-0002-2912-3808МалхасьянМ. В.MalkhasyanM. V.

Малхасьян Максим Викторович, врач-хирург

628011, Ханты- Мансийск, ул. Калинина, д. 40

Maksim V. Malkhasyan, Surgeon

40, Kalinin St., Khanty-Mansiysk, 628011

mmv086@yandex.ruhttps://orcid.org/0009-0005-2791-1132ЛалетинаЕ. В.LaletinaE. V.

Лалетина Екатерина Вячеславовна, врач-терапевт

628011, Ханты- Мансийск, ул. Калинина, д. 40

Ekaterina V. Laletina, Physician

40, Kalinin St., Khanty-Mansiysk, 628011

cat.shilova@yandex.ruХанты-Мансийская государственная медицинская академияРоссияKhanty-Mansiysk State Medical AcademyRussian FederationРоссийская медицинская академия непрерывного последипломного образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian FederationОкружная клиническая больницаРоссияDistrict Clinical HospitalRussian Federation202501122025019219–226Copyright © Гирина А.А., Томрачева Л.В., Заплатников А.Л., Малхасьян М.В., Лалетина Е.В., 20252025Гирина А.А., Томрачева Л.В., Заплатников А.Л., Малхасьян М.В., Лалетина Е.В.Girina A.A., Tomracheva L.V., Zaplatnikov A.L., Malkhasyan M.V., Laletina E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9608Введение

Введение. Инфекции, вызванные Streptococcus pneumoniae, по-прежнему остаются одной из глобальных проблем здравоохранения. Наиболее уязвимыми для пневмококковых инфекций являются дети первых 5 лет жизни, а также взрослые старше 60 лет и пациенты с различными тяжелыми хроническими заболеваниями и иммунодефицитными состояниями.

Цель

Цель. Изучить изменения в частоте носительства S. pneumoniae и в структуре его серотипового состава на фоне пневмококковой вакцинации детей, посещающих дошкольные образовательные учреждения (организованные дети).

Материалы и методы

Материалы и методы. Изучена динамика изменений частоты носительства S. pneumoniae и структуры пейзажа его серотипов на фоне вакцинации ПКВ13 у 1 350 организованных детей в возрасте от 1 года до 5 лет 11 мес. 29 дней (средний возраст – 4,43 ± 0,31 года). В исследование были включены 510 детей в 2016–2018 гг. и 840 детей в 2020–2022 гг. Работа выполнена в рамках международного проспективного многоцентрового исследования SAPIENS (Scientific Assessment of Pneumococcal Infection Epidemiology Networks) в г. Ханты- Мансийске.

Результаты и обсуждение

Результаты и обсуждение. Установлено, что на фоне вакцинации частота носительства S. pneumoniae снизилась в целом с 55,9% до 34,2% (р < 0,05). Уменьшение носительства пневмококка имело место во всех возрастных группах: у детей 1–2 лет – с 64,3% до 51,0%; 3 лет – с 63,6% до 37,6%; 4 лет – с 58,3% до 35,0%; 5 лет – с 47,1% до 28,4% (до и после вакцинации соответственно). В связи с этим обсуждается необходимость мониторирования носительства S. pneumoniae с обязательным определением его серотиповой структуры для своевременной замены вакцины. Представлены данные литературы по безопасности и иммунологической эффективности пневмококковой полисахаридной конъюгированной адсорбированной 20-валентной вакцины, которая, помимо капсулярных полисахаридов тех серотипов пневмококка, которые входят в ПКВ13, дополнительно содержит капсулярные полисахариды.

Выводы

Выводы. Вакцинация против пневмококковой инфекции, проводимая в рамках национального календаря прививок, позволила существенно – в 1,6 раза (р < 0,05) – снизить уровень носительства S. pneumoniae у организованных детей дошкольного возраста.

Introduction

Introduction. Streptococcus pneumoniae infections remain one of the global public health concerns. The most vulnerable groups for pneumococcal infections include children in their first 5 years of life, as well as adults aged >60 years and patients with various severe chronic diseases and immunodeficiency disorders.

Aim

Aim. To study changes in S. pneumoniae carriage rates and its serotype composition structure due to pneumococcal vaccination of children attending preschool educational institutions (institutionalized children).

Materials and methods

Materials and methods. We studied the trends of changes in S. pneumoniae carriage rates and its serotype landscape structure due to PCV13 vaccination in 1 350 institutionalized children aged 1 to 5 years 11 months and 29 days (the mean age was 4.43 ± 0.31 years). A total of 510 children were included in the study in 2016–2018 and 840 children in 2020–2022. The work was carried out within the framework of the international prospective multicenter study SAPIENS (Scientific Assessment of Pneumococcal Infection Epidemiology Networks) in the city of Khanty-Mansiysk.

Results and discussion

Results and discussion. The overall S. pneumoniae carriage rates were found to be reduced from 55.9% to 34.2% (р < 0.05). The reduction in pneumococcal carriage rates was observed in all age groups: in children aged 1–2 years old – from 64.3% to 51.0%; 3 years – from 63.6% to 37.6%? 4 years – from 58.3% to 35.0%; 5 years – from 47.1% to 28.4% (before and after vaccination respectively). Thus, the importance of monitoring S. pneumoniae carriage rates with the necessary determination of its serotype structure for the timely replacement of the vaccine is discussed. We presented the literature data on the safety and immunological efficacy of the 20-valent pneumococcal polysaccharide conjugate adsorbed vaccine, which contains capsular polysaccharides (CPSs) in addition to the CPSs of the pneumococcal serotypes that were included in PCV13.

Conclusions

Conclusions. Pneumococcal vaccination within the national vaccination schedule has significantly (1.6 times (р < 0.05)) reduced the S. pneumoniae carriage rates in the institutionalized preschool children.

вакцина пневмококковая полисахаридная конъюгированная адсорбированная 13-валентнаявакцина пневмококковая полисахаридная конъюгированная адсорбированная 20-валентнаявакцинациядетипневмококковая инфекцияорганизованные детипневмококкS. pneumoniae3-valent pneumococcal polysaccharide conjugate adsorbed vaccine20-valent pneumococcal polysaccharide conjugate adsorbed vaccinevaccinationchildrenpneumococcal infectioninstitutionalized childrenpneumococcusS. pneumoniaeReferencesБрико НИ, Коршунов ВА, Ломоносов КС. Пневмококковая инфекция в Российской Федерации: состояние проблемы. Вестник Российской академии медицинских наук. 2021;76(1):28–42. https://doi.org/10.15690/vramn1404.Брико НИ, Коршунов ВА, Ломоносов КС. Пневмококковая инфекция в Российской Федерации: состояние проблемы. Вестник Российской академии медицинских наук. 2021;76(1):28–42. https://doi.org/10.15690/vramn1404.Streptococcus pneumoniae (Pneumococcal) infections. In: Kimberlin DW, Barnett E, Lynfield R, Sawyer MH. (eds.). 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The authors declare that there are no conflicts of interest present.