Li Yue, Wang Sijie, Hong Liang, Xin Lijing, Wang Fei, Zhou Yibin
Department of Integrated Operations Management, Hongkou District Center for Disease Control and Prevention, Shanghai, People's Republic of China.
Shanghai Institute of Major Infectious Disease and Biosafety, and Institutes of Biomedical Sciences, Fudan University, Shanghai, China.
Pneumonia (Nathan). 2024 Oct 5;16(1):18. doi: 10.1186/s41479-024-00141-z.
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.
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.
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.
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.
肺炎链球菌是全球儿童发病和死亡的主要原因，其不断演变的血清型分布和抗生素耐药模式引起了全球健康关注。本荟萃分析旨在调查13价肺炎球菌结合疫苗（PCV13）作为自费疫苗在中国儿科人群中引入后肺炎链球菌的血清型分布和抗菌药物耐药性。
我们系统回顾了2017年至2024年间发表的聚焦于从中国大陆14岁以下儿童中分离出的肺炎链球菌血清型的研究。数据来源包括PubMed、Embase、Web of Science、CNKI、万方和中国生物医学文献数据库。研究结果采用固定效应模型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，确定肺炎链球菌最常见的血清型为19F、19A、23F、14、6B和6A。PCV10的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%）。对红霉素的抗菌药物耐药性最为明显，为93.73%（95%CI：90.58 - 96.88%），其次是阿奇霉素、四环素、克林霉素和磺胺甲恶唑。血清型流行率和疫苗覆盖率因地区和菌株类型而异。
在中国大陆，作为自费疫苗引入PCV13后，14岁以下儿童肺炎链球菌血清型的分布及其抗生素耐药谱保持相对稳定。研究结果支持继续使用并可能扩大PCV13免疫接种，并强调持续监测和疫苗研发以覆盖中国所有流行血清型的重要性。
