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. 2024 Nov 5;16(1):29.
doi: 10.1186/s41479-024-00152-w.

Streptococcus pneumoniae serotype distribution in Bangladeshi under-fives with community-acquired pneumonia pre-10-valent pneumococcal conjugate vaccination

Stefan M T Vestjens  1   2 , Suzan P van Mens  3   4 , Bob Meek  3 , Tariq A Lalmahomed  5 , Ben de Jong  3 , Doli Goswami  6 , Bart J M Vlaminckx  3 , Dilruba Ahmed  6 , Bartelt M de Jongh  3 , Hubert P Endtz  6   7 , W Abdullah Brooks  6   8 , Ger T Rijkers  3   5
Affiliations

Streptococcus pneumoniae serotype distribution in Bangladeshi under-fives with community-acquired pneumonia pre-10-valent pneumococcal conjugate vaccination

Stefan M T Vestjens et al. Pneumonia (Nathan). .

Abstract

Background: Streptococcus pneumoniae is the most frequent causative pathogen of bacterial pneumonia in children worldwide. Bangladesh introduced the 10-valent pneumococcal conjugate vaccine (PCV10) in their national immunization program for infants in 2015. We assessed its potential coverage in under-fives with community-acquired pneumonia (CAP) in the years before PCV10 was introduced.

Methods: A total of 1502 childhood pneumonia cases (< 5 year olds living in the urban section Kamalapur, Dhaka) were enrolled between 2011 and 2013. Acute phase and late (convalescent) serum samples were collected from 1380 cases. Serotype-specific pneumococcal antibody concentrations were measured using a 25-plex immunoassay panel. Pneumococcal CAP was diagnosed based on a serotype-specific pneumococcal antibody response.

Results: S. pneumoniae was serologically identified as causative pathogen in 406/1380 (29%) cases. The five most prevalent serotypes were (in descending order) 11A, 22F, 3, 2 and 19F. Based on the percentage of pneumonia cases associated with PCV10 vaccine types, the potential PCV10 coverage was 29% (116/406).

Conclusions: In almost a third of the studied cases S. pneumoniae was identified as a causative pathogen. Because of the characteristics of the immunoassay, this might well be a gross underestimation. Nevertheless, the potential PCV10-coverage was low. Given the high serotype diversity, the region might benefit greatly from a higher-coverage PCV or recombinant protein vaccine.

Keywords: Bangladesh; Children; Pneumococcal; Pneumonia; Serotypes.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Distribution of serotypes causing pneumococcal CAP based on serotype-specific antibody responses. Bars indicate the number of cases, the line shows the proportion. Proportion of PCV10 coverage is shown in the right upper corner
Fig. 2
Fig. 2
The overall serotype distribution based on serotype-specific antibody responses stratified by age group. Bars indicate the number of cases. Proportion of PCV10 coverage is shown in the left upper corner
See this image and copyright information in PMC

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