Ashrafian Fatemeh, Sadat Larijani Mona, Haji Maghsoudi Saiedeh, Doroud Delaram, Fahimzad Alireza, Pournasiri Zahra, Jafari Elham, Parzadeh Masoumeh, Abdollahi Sara, Haj Agha Gholizadeh Khiavi Elham, Bavand Anahita, Shafiei Morvarid, Rohani Mahdi, Ramezani Amitis
Clinical Research Department, Pasteur Institute of Iran, No: 69, Pasteur Ave, Tehran 1316943551, Iran.
Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman 7616913555, Iran.
Vaccines (Basel). 2025 Jun 29;13(7):707. doi: 10.3390/vaccines13070707.
: Pneumococcal pneumonia is a major cause of death globally, emphasizing the importance of vaccination, especially in low- and middle-income countries. In Iran, the 13-valent pneumococcal conjugate vaccine (PCV13) is available exclusively through private healthcare systems, resulting in a lack of studies on the prevalence of () serotypes among vaccinated children. This research aimed to explore and compare the prevalence of nasopharyngeal pneumococcal carriage, serotype distribution, and antibiotic resistance patterns in healthy PCV13-vaccinated and -unvaccinated children. : From August 2023 to November 2024, a multi-center, cross-sectional observational study was conducted in Tehran, Iran. This study included 204 nasopharyngeal samples collected from children aged from 18 to 59 months, involving both cases of children vaccinated with PCV13 and unvaccinated populations. was identified through a combination of culture methods and biochemical tests, confirmed by real-time PCR. Serotyping was achieved using sequencing, and the minimum inhibitory concentration method was employed to assess antibiotic resistance. : This study revealed similar carriage rates between PCV13-vaccinated and -unvaccinated Iranian children (20.6% vs. 21.6%). Serotypes 23F and 19F were prevalent in unvaccinated children, while 15B/15C was more prevalent in PCV13-vaccinated children. The included serotypes in PCV13 were detected more in the unvaccinated group. PCV13-vaccinated children exhibited no penicillin-resistant pneumococcal isolates, although four isolates were non-susceptible in unvaccinated children. Both groups showed substantial resistance to erythromycin and SXT. Previous respiratory infections, daycare attendance, residence in Tehran, and a history of antibiotic consumption increased the risk of pneumococcal carriage. : PCV13 vaccination influences pneumococcal serotype distribution and antimicrobial susceptibility, although there was no significant difference regarding carriage rates between vaccinated and unvaccinated groups. These findings highlight the critical importance of vaccination in reducing invasive serotypes and antimicrobial resistance in children under five years old, emphasizing the importance of national PCV vaccination programs alongside continuous serotype surveillance.
肺炎球菌肺炎是全球主要的死亡原因之一，这凸显了疫苗接种的重要性，尤其是在低收入和中等收入国家。在伊朗，13价肺炎球菌结合疫苗（PCV13）仅通过私立医疗系统提供，导致缺乏关于接种疫苗儿童中（）血清型流行情况的研究。本研究旨在探索和比较健康的接种PCV13和未接种PCV13儿童的鼻咽部肺炎球菌携带率、血清型分布及抗生素耐药模式。：2023年8月至2024年11月，在伊朗德黑兰进行了一项多中心横断面观察性研究。本研究纳入了204份从18至59个月大儿童采集的鼻咽样本，涉及接种PCV13的儿童和未接种疫苗的人群。通过培养方法和生化试验相结合进行鉴定，并经实时PCR确认。使用（）测序进行血清分型，采用最低抑菌浓度法评估抗生素耐药性。：本研究显示，伊朗接种PCV13和未接种PCV13的儿童肺炎球菌携带率相似（20.6%对21.6%）。23F和19F血清型在未接种疫苗的儿童中较为普遍，而15B/15C在接种PCV13的儿童中更为普遍。PCV13中包含的（）血清型在未接种疫苗组中检测到的更多。接种PCV13的儿童未出现耐青霉素的肺炎球菌分离株，尽管在未接种疫苗的儿童中有4株分离株不敏感。两组对红霉素和复方新诺明均表现出较高的耐药性。既往呼吸道感染、日托出勤、居住在德黑兰以及有抗生素使用史会增加肺炎球菌携带风险。：PCV13疫苗接种会影响肺炎球菌血清型分布和抗菌药物敏感性，尽管接种组和未接种组之间的携带率没有显著差异。这些发现凸显了疫苗接种在降低五岁以下儿童侵袭性血清型和抗菌药物耐药性方面的至关重要性，强调了国家PCV疫苗接种计划以及持续血清型监测的重要性。
