Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae in China among children under 14 years of age post-implementation of the PCV13: a systematic review and meta-analysis (2017-2024).

IF 8.5 Q1 RESPIRATORY SYSTEM
Yue Li, Sijie Wang, Liang Hong, Lijing Xin, Fei Wang, Yibin Zhou
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Abstract

Background: Streptococcus pneumoniae (S. pneumoniae) is a major cause of morbidity and mortality in children worldwide, and its evolving serotype distribution and antibiotic resistance patterns are of global health concern. This meta-analysis aims to investigate the serotype distribution and antimicrobial resistance of S. pneumoniae after the introduction of pneumococcal conjugate vaccine 13-valent (PCV13) as a self-funded vaccine in Chinese pediatric populations.

Methods: We systematically reviewed studies published between 2017 and 2024 that focused on S. pneumoniae serotypes isolated from children under 14 years old in mainland China. Data sources included PubMed, Embase, Web of Science, CNKI, Wanfang, and SinoMed. The findings were synthesized using either a fixed-effects or random-effects model.

Results: Our meta-analysis included 12 studies, identifying the most common serotypes of S. pneumoniae were 19 F, 19 A, 23 F, 14, 6B and 6 A. Vaccine serotype coverage rates were 52.17% (95%CI: 44.91-59.42%) for PCV10, 74.77% (95%CI: 71.53-78.01%) for PCV13, 76.72% (95%CI: 75.37-78.07%) for PCV15 and 92.90% (95%CI: 92.09-93.71%) for PPSV23. Antimicrobial resistance was most pronounced for erythromycin at 93.73% (95%CI: 90.58-96.88%), followed by azithromycin, tetracycline, clindamycin, and sulfamethoxazole. Serotype prevalence and vaccine coverage varied regionally and by strain type.

Conclusion: The distribution of S. pneumoniae serotypes and their antibiotic resistance profiles in children under 14 years in mainland China have remained relatively stable post-PCV13 introduction as a self-funded vaccine. The results support continued use and possible expansion of PCV13 immunization and highlight the importance of ongoing surveillance and vaccine development to cover all prevalent serotypes in China.

PCV13 实施后中国 14 岁以下儿童肺炎链球菌的血清型分布和抗菌药耐药性:系统综述和荟萃分析(2017-2024 年)。
背景:肺炎链球菌(S. pneumoniae)是导致全球儿童发病和死亡的主要原因之一,其不断变化的血清型分布和抗生素耐药性模式引起了全球健康关注。本荟萃分析旨在研究中国儿科人群自费接种肺炎球菌结合疫苗13价(PCV13)后肺炎球菌的血清型分布和抗菌药耐药性:我们系统地回顾了 2017 年至 2024 年间发表的关于中国大陆 14 岁以下儿童肺炎球菌血清型的研究。数据来源包括 PubMed、Embase、Web of Science、CNKI、Wanfang 和 SinoMed。研究结果采用固定效应或随机效应模型进行综合分析:我们的荟萃分析纳入了 12 项研究,确定了最常见的肺炎双球菌血清型为 19 F、19 A、23 F、14、6 B 和 6 A。PCV10 疫苗血清型覆盖率为 52.17%(95%CI:44.91-59.42%),PCV13 为 74.77%(95%CI:71.53-78.01%),PCV15 为 76.72%(95%CI:75.37-78.07%),PPSV23 为 92.90%(95%CI:92.09-93.71%)。抗菌药耐药性最明显的是红霉素,为 93.73%(95%CI:90.58-96.88%),其次是阿奇霉素、四环素、克林霉素和磺胺甲噁唑。血清型流行率和疫苗覆盖率因地区和菌株类型而异:结论:中国大陆 14 岁以下儿童肺炎球菌血清型的分布及其抗生素耐药性情况在 PCV13 作为自费疫苗引入后保持相对稳定。这些结果支持继续使用 PCV13 并可能扩大其免疫范围,同时强调了持续监测和疫苗开发以覆盖中国所有流行血清型的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pneumonia
Pneumonia RESPIRATORY SYSTEM-
自引率
1.50%
发文量
7
审稿时长
11 weeks
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