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한국 훈련병에서 수막염균 보균에 대한 4가 수막염균 결합 백신의 영향
허중연 ( Jung Yeon Heo ),배송미 ( Song-mee Bae ),정희진 ( Hee Jin Cheong ),김우주 ( Woo Joo Kim ),김민영 ( Min Young Kim ),나원웅 ( Wonwoong Na ),최강원 ( Kang-won Choe ),천병철 ( Byung Chul Chun ) 국군의무사령부 2014 대한군진의학학술지 Vol.45 No.1
Background: Monovalent meningococcal conjugate vaccines against serogroup A or C had resulted in significant reduction of pharyngeal carriage rates against respective vaccine serogroup. However, the effect of quadrivalent meningococcal conjugate vaccine on meningococcal carriage has not been evaluated. We assessed on changing pharyngeal carriage rate of Neisseria meningitidis after the introduction of quadrivalent meningococcal conjugate vaccine in Korean military trainees. Methods: Twice oropharyngeal swabs were conducted at the beginning and end of army training period in Korean military trainees. First oropharyngeal swabs were undertaken prior to vaccination. Second round of swabbing was done 5 weeks later. Results: In 2013, overall carriage rate of N. meningitidis was higher at the end of training period (13.8%, 60 of 434 participants) than on entry of military service (8.9%, 39 of 434 participants). Although carriage rate of nongroupable and serogroup X isolates were increased over 5-week interval, carriage strains of vaccine serogroup, which were included serogroups in quadrivalent meningococcal vaccine, were relatively reduced from 7 to 2 isolates following vaccination. However, in 2014, overall carriage rate of N. meningitidis was significantly lower at the end of training period (5.2%, 23 of 443 participants) than on entry of military service (12.6%, 56 of 443 participants) (p=0.028). Carriage isolates of vaccine serogroups were significantly decreased with that of non-vaccine serogroup B over 5-week interval (p=0.006). Conclusion: Meningococcal vaccination in Korean military trainees resulted in reduction of pharyngeal carriage rates of not only vaccine serogroup meningococci but non-vaccine serogroup B. Quadrivalent meningococcal conjugate vaccine is likely to preventing carriage acquisition of meningococci in a closed population.
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