Huang Lili, King Alannah C, Liu Yue, Hung Harry C H, Bentley Stephen D, Jiang Yue, Lv Panpan, Xu Xuebin, Lo Stephanie W, Chen Mingliang
Laboratory Department, Children's Hospital of Soochow University, Suzhou, Jiangsu, PR China.
Parasites and Microbes, The Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK.
Microb Genom. 2025 Jun;11(6). doi: 10.1099/mgen.0.001398.
In 2017, 553,000 clinical cases of in children were reported in China, although the pneumococcal conjugate vaccine (PCV), which targets the pneumococcal capsule, is not included in the Chinese National Immunization Program (NIP) for children. Therefore, the PCV uptake rate is very low. To investigate the population over the past 10 years in China, we collected 418 S. isolates from children with pneumococcal diseases in Suzhou, China, 2014-2023, and whole-genome sequenced them. A total of 27 serotypes expressed by 36 Global Pneumococcal Sequence Clusters (GPSCs) that encompassed 72 sequence types were identified, with serotype 19F (38.3%, =160) and GPSC1 (60.8%, =254) as the predominant serotype and lineage, respectively. We found that the majority (64.8%, =271) of samples represented serotypes that are covered by the GSK 10-valent PCV (PCV10) formulation and that even more were covered by the SII PCV10 formulation (89.2%, =373). Almost all (94.3%, =394) samples represented serotypes that are included within the 13-valent PCV (PCV13) vaccine formulation. This suggests that the inclusion of the PCV in the NIP would lead to significant benefits for child health. Also, we observed that no significant differences were seen in the serotypes or lineages in cases of invasive and non-invasive pneumococcal diseases.Additionally, we investigated the prevalence of antimicrobial resistance within the population and found that 99.8% (=417) of isolates were predicted to be resistant to at least one antibiotic tested. This again supports the need to increase PCV uptake to prevent infections with antibiotic-resistant and to reduce the number of infections in general, consequently lowering the consumption of antibiotics. In summary, the PCV13 vaccine could potentially cover over 90% of invasive and non-invasive isolates in Suzhou, China. Therefore, increasing the uptake of PCVs by including PCV13 in the NIP would lead to significant benefits for child health.
2017年，中国报告了55.3万例儿童临床病例，尽管针对肺炎球菌荚膜的肺炎球菌结合疫苗（PCV）未被纳入中国国家儿童免疫规划（NIP）。因此，PCV的接种率非常低。为了调查中国过去10年的肺炎球菌种群，我们收集了2014年至2023年期间中国苏州肺炎球菌疾病患儿的418株肺炎链球菌分离株，并对它们进行了全基因组测序。共鉴定出由36个全球肺炎球菌序列簇（GPSCs）表达的27种血清型，这些序列簇包含72种序列类型，其中血清型19F（38.3%，n = 160）和GPSC1（60.8%，n = 254）分别为主要血清型和谱系。我们发现，大多数样本（64.8%，n = 271）代表的血清型被葛兰素史克10价PCV（PCV10）配方所覆盖，甚至更多的样本被印度血清研究所PCV10配方所覆盖（89.2%，n = 373）。几乎所有样本（94.3%，n = 394）代表的血清型都包含在13价PCV（PCV13）疫苗配方中。这表明将PCV纳入NIP将给儿童健康带来显著益处。此外，我们观察到侵袭性和非侵袭性肺炎球菌疾病病例的血清型或谱系没有显著差异。另外，我们调查了该种群内的抗菌药物耐药性流行情况，发现99.8%（n = 417）的分离株预计对至少一种测试抗生素耐药。这再次支持了提高PCV接种率以预防抗生素耐药肺炎链球菌感染并总体减少感染数量从而降低抗生素消耗量的必要性。总之，PCV13疫苗可能覆盖中国苏州90%以上的侵袭性和非侵袭性肺炎链球菌分离株。因此，通过将PCV13纳入NIP来提高PCV的接种率将给儿童健康带来显著益处。
