Impact of PCV on disease and colonization among Native American communities

PCV 对美洲原住民社区疾病和定植的影响

• 批准号: 7808442
• 负责人: Eugene Vincent Millar
• 金额: $ 33.49万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-25 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7808442
• 关键词: 5 year old; Adult; Affect; American Indians; Antibiotic Resistance; Antibodies; Apache Indians; Bacteria; Bacterial Polysaccharides; Blood; Cessation of life; Characteristics; Child; Clonal Expansion; Communities; Conjugate Vaccines; Data; Data Set; Developed Countries; Developing Countries; Development; Disease; Ecology; Effectiveness; Elderly; Ensure; Family; Future; Genomics; Germ; Goals; Health; Hospitalization; Household; Immunization Schedule; Immunoglobulins; Incidence; Individual; Infant; Infection; Licensing; Licensure; Manuscripts; Meningitis; Methods; Microarray Analysis; Molecular; Molecular Epidemiology; Native Americans; Navajo; Nose; One-Step dentin bonding system; Organism; Pattern; Persons; Pharmaceutical Preparations; Pharyngeal structure; Phase; Pneumococcal 7-Valent Conjugate Vaccine; Pneumococcal Colonization; Pneumococcal Infections; Pneumococcal conjugate vaccine; Pneumococcal vaccine; Pneumonia; Polyvalent pneumococcal vaccine; Population; Preparation; Prevalence; Prevention; Prevention strategy; Proteins; Randomized Controlled Clinical Trials; Research; Research Project Grants; Reservations; Resistance development; Serotyping; Sinusitis; Stream; Streptococcus pneumoniae; Structure; Testing; Time; Toddler; Tribes; United States; Ursidae Family; Vaccinated; Vaccination; Vaccine Design; Vaccines; age group; bacterial polysaccharide immune globulin; disorder prevention; ear infection; expectation; health disparity; high risk; improved; meetings; novel vaccines; population based; pressure; prevent; programs; success; tool; transmission process

DESCRIPTION (provided by the applicant): Pneumococcus is a bacterium that healthy people commonly have in their nose and throat; this is called pneumococcal 'carriage'. Carriage is usually harmless, but can progress to serious disease like pneumonia, meningitis, and blood stream infections or to less serious, but burdensome, diseases like sinusitis or ear infections. Infants and the elderly bear the greatest burden of pneumococcal disease with over 800,000 annual global deaths from this germ among children under 5 years of age. Furthermore, pneumococcus has developed resistance to antibiotics making it increasingly difficult to treat pneumococcal infections. Within the United States some Native American groups, like the Navajo and the White Mountain Apache tribes, suffer from pneumococcal disease much more often than people in the general US population. We don't know why pneumococcus disproportionately afflicts these communities, but we know this health disparity can be significantly reduced through vaccination. In 2000 for the first time a pneumococcal vaccine designed specifically for infants, called PCV7, became available and was put into routine use among Navajo, Apache as well as the general US population. PCV7 contains the 7 most common of the >90 pneumococcal strains that exist. Although PCV7 is only given to infants and toddlers, it impacts pneumococcal disease throughout the community because it not only protects vaccinated infants from disease it also protects them against NP colonization. Infants and children are the main transmitters of pneumococcal colonization in the community so any change in their carriage affects the whole population of pneumococcal germs circulating within the family and community. Reductions in pneumococcal disease caused by the 7 types in PCV7 have exceeded expectations, especially among Navajo and Apache where we have seen no cases in over 4 years. But, PCV7 has had the unintended consequence of increasing the amount of pneumococcal disease from some pneumococcal types that are not in PCV7. Therefore a new vaccine to protect against 13 pneumococcal strains, called PCV13, is about to be licensed and used. This project aims to reveal the impact of PCV13 on pneumococcal disease and carriage of strains which move from person to person within the Navajo and Apache communities. We specifically intend to find out if use of PCV13 has an effect on disease and carriage of the 6 additional strains in the vaccine and to find out if PCV13 will result in the emergence of new pneumococcal serotypes within the community, like PCV7 did. This information will allow us to design vaccine strategies to meet these new patterns of pneumococcal disease and stay at least one step ahead of the organism changes.

描述（由申请人提供）：肺炎球菌是健康人通常在鼻子和喉咙中患有的细菌；这称为肺炎球菌“马车”。马车通常是无害的，但可以发展为严重疾病，例如肺炎，脑膜炎和血流感染，或者不那么严重，但繁重的疾病如鼻窦炎或耳部感染。婴儿和老年人承担着肺炎球菌疾病的最大负担，在5岁以下的儿童中，该细菌年度超过800,000例全球死亡。此外，肺炎球菌已经对抗生素产生了抗药性，使得治疗肺炎球菌感染变得越来越困难。在美国，一些美国原住民群体，例如纳瓦霍人和白山阿帕奇部落，比美国普通人群中的肺炎球菌疾病更频繁。我们不知道为什么肺炎球菌不成比例地困扰着这些社区，但是我们知道通过疫苗接种可以大大降低这种健康差异。 2000年，第一次专门为婴儿设计的肺炎球菌疫苗（称为PCV7）可用，并在纳瓦霍（Navajo），阿帕奇（Apache）和美国普通人群中常规使用。 PCV7包含存在的> 90个肺炎球菌菌株中最常见的7个。尽管PCV7仅给了婴儿和幼儿，但它影响了整个社区的肺炎球菌疾病，因为它不仅可以保护接种疫苗的婴儿免受疾病的侵害，还可以保护他们免受NP定殖。婴儿和儿童是社区中肺炎球菌定殖的主要发射器，因此，其运输的任何变化都会影响家庭和社区中流传的肺炎球菌的整个种群。由PCV7中7种类型引起的肺炎球菌疾病的减少已经超出了预期，尤其是在纳瓦霍人和阿帕奇中，我们在4年中没有看到任何病例。但是，PCV7的意外结果是增加了一些不在PCV7中的肺炎球菌类型的肺炎球菌疾病量。因此，一种用于预防13个肺炎球菌菌株（称为PCV13）的新疫苗即将获得许可和使用。该项目旨在揭示PCV13对肺炎球菌疾病的影响以及在纳瓦霍人和阿帕奇社区内从人到人的菌株的运输。我们特别打算找出PCV13的使用是否对疫苗中6种其他菌株的疾病和运输是否有影响，并确定PCV13是否会导致社区内新的肺炎球菌血清型出现，就像PCV7一样。这些信息将使我们能够设计疫苗策略，以满足肺炎球菌疾病的这些新模式，并至少领先于生物体变化一步。