Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2012 May 28:12:124.
doi: 10.1186/1471-2334-12-124.

Streptococcus pneumoniae serotype 19A in Latin America and the Caribbean: a systematic review and meta-analysis, 1990-2010

Elizabeth Castañeda  1 , Clara Inés Agudelo, Rodrigo De Antonio, Diego Rosselli, Claudia Calderón, Eduardo Ortega-Barria, Rómulo E Colindres
Affiliations
Meta-Analysis

Streptococcus pneumoniae serotype 19A in Latin America and the Caribbean: a systematic review and meta-analysis, 1990-2010

Elizabeth Castañeda et al. BMC Infect Dis. .

Abstract

Background: Pneumococcal conjugate vaccines (PCVs) are in the process of implementation in Latin America. Experience in developed countries has shown that they reduce the incidence of invasive and non-invasive disease. However, there is evidence that the introduction of PCVs in universal mass vaccination programs, combined with inappropriate and extensive use of antibiotics, could be associated to changes in non-PCV serotypes, including serotype 19A. We conducted a systematic review to determine the distribution of serotype 19A, burden of pneumococcal disease and antibiotic resistance in the region.

Methods: We performed a systematic review of serotype 19A data from observational and randomized clinical studies in the region, conducted between 1990 and 2010, for children under 6 years. Pooled prevalence estimates from surveillance activities with confidence intervals were calculated.

Results: We included 100 studies in 22 countries and extracted data from 63. These data reported 19733 serotyped invasive pneumococcal isolates, 3.8% of which were serotype 19A. Serotype 19A isolates were responsible for 2.4% acute otitis media episodes, and accounted for 4.1% and 4.4% of 4,380 nasopharyngeal isolates from healthy children and in hospital-based/sick children, respectively. This serotype was stable over the twenty years of surveillance in the region. A total of 53.7% Spn19A isolates from meningitis cases and only 14% from non meningitis were resistant to penicillin.

Conclusions: Before widespread PCV implementation in this region, serotype 19A was responsible for a relatively small number of pneumococcal disease cases. With increased use of PCVs and a greater number of serotypes included, monitoring S. pneumoniae serotype distribution will be essential for understanding the epidemiology of pneumococcal disease.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow diagram of the literature reviewed.
Figure 2
Figure 2
Streptococcus pneumoniae serotype 19A distribution of invasive isolates SIREVA data, 2000–2005, 2006, 2007, 2008, 2009.
Figure 3
Figure 3
a Serotype 19A meta-analysis of invasive isolates. b Serotype 19A meta-analysis of AOM isolates. c Serotype 19A meta-analysis healthy nasopharyngeal carriers. d Serotype 19A meta-analysis sick carriers.
See this image and copyright information in PMC

References

    1. Lynch JP 3rd, Zhanel GG. Streptococcus pneumoniae: epidemiology and risk factors, evolution of antimicrobial resistance, and impact of vaccines. Curr Opin Pulm Med. 2010;16:217–225. - PubMed
    1. O'Brien KL, Wolfson LJ, Watt JP, Henkle E, Deloria-Knoll M, McCall N, Lee E, Mulholland K, Levine OS, Cherian T. Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates. Lancet. 2009;374:893–902. doi: 10.1016/S0140-6736(09)61204-6. Hib and Pneumococcal Global Burden of Disease Team: - DOI - PubMed
    1. Levine OS, Knoll MD, Jones A, Walker DG, Risko N, Gilani Z. Global status of Haemophilus influenzae type b and pneumococcal conjugate vaccines: evidence, policies, and introductions. Curr Opin Infect Dis. 2010;23:236–241. doi: 10.1097/QCO.0b013e328338c135. - DOI - PubMed
    1. Johnson HL, Deloria-Knoll M, Levine OS, Stoszek SK, Freimanis Hance L, Reithinger R, Muenz LR, O'Brien KL. Systematic evaluation of serotypes causing invasive pneumococcal disease among children under five: the pneumococcal global serotype project. PLoS Med. 2010;7:e1000348. doi: 10.1371/journal.pmed.1000348. - DOI - PMC - PubMed
    1. Satzke C, Ortika BD, Oftadeh S, Russell FM, Robins-Browne RM, Mulholland EK, Gilbert GL. Molecular epidemiology of Streptococcus pneumoniae serogroup 6 isolates from Fijian children, including newly identified serotypes 6C and 6D. J Clin Microbiol. 2010;48:4298–4300. doi: 10.1128/JCM.00861-10. - DOI - PMC - PubMed

Publication types

MeSH terms

Substances