Distribution of capsule and O types in Klebsiella pneumoniae causing neonatal sepsis in Africa and South Asia: A meta-analysis of genome-predicted serotype prevalence to inform potential vaccine coverage

作者：Thomas D. Stanton, Shaun P Keegan, Jabir A. Abdulahi, Anne V. Amulele, Matthew T Bates, Eva Heinz, Yogesh Hooda, Weiming Hu, Kajal Jain, Samiah Kanwar, Rindidzani E. Magobo, Courtney P. Olwagen, John Tembo, Tolbert Sonda, Jonathan Strysko, Caroline Tigoi, S. Amin, Kyle Bittinger, J. W. Cornick, Ebenezer Foster-Nyarko, Wilson Gumbi, Aneeta Hotwani, Naveed Iqbal, Steven M. Jones, Furqan Kabir, Waqasuddin Khan, Chileshe Lukwesa Musyani, Carolyn McGann, Varsha Mittal, Ahmed M. Moustafa, Patrick Musicha, James C. L. Mwansa, Moreka L Ndumba, Erkison E. Odih, Donwilliams O. Omuoyo, Oliver Pearse, Laura Phillips, Paul J. Planet, Aniqa Abdul Rasool, Charlene M. C. Rodrigues, Kirsty Sands, Arif M. Tanmoy, Erin Theiller, Allan Zuza, Sulagna Basu, Grace J. Chan, Kenneth C. Iregbu, Jean-Baptiste Mazarati, Semaria Solomon Alemayehu, Timothy R. Walsh, Rabaab Zahra, Angela Dramowski, Sombo Fwoloshi, Appiah-Korang Labi, Lola Madrid, Noah Obeng‐Nkrumah, David Ojok, Boaz Wadugu, Andrew C. Whitelaw, Adhisivam Bethou, Anudita Bhargava, Atul Jindal, Ruchi Nanavati, Priyanka S. Prasad, Apurba Sastry, Joveria Farooqi, Najia Ghanchi, Fyezah Jehan, Erum Khan, Ramesh K. Agarwal, Alexander M. Aiken, James A. Berkley, Susan E. Coffin, Nicholas A. Feasey, Nelesh P. Govender, Davidson H. Hamer, Shabir A. Madhi, Muhammad Imran Nisar, Samir K. Saha, Senjuti Saha, Mari Jeeva Sankar, Kelly L. Wyres, Kathryn E. Holt · 发表于：PLoS Medicine · 年份：2026 · DOI：10.1371/journal.pmed.1004879 · 被引用次数：4 · 研究领域：Neonatal and Maternal Infections、Antibiotic Resistance in Bacteria、Pneumonia and Respiratory Infections

BACKGROUND: Klebsiella pneumoniae causes ~20% of sepsis in neonates, with ~40% crude mortality. A vaccine administered to pregnant women, protecting against ≥70% of K. pneumoniae infections, could avert ~400,000 cases and ~80,000 deaths annually, mostly in Africa and South Asia. Vaccine formulations targeting the capsular polysaccharide (K) or lipopolysaccharide (O) antigens are in development. Global K. pneumoniae populations display extensive K and O diversity, necessitating a polyvalent vaccine targeted to the serotypes associated with neonatal disease in relevant geographical regions. We investigated the prevalence of K and O types associated with neonatal sepsis in Africa and South Asia to inform maternal vaccine design. METHODS AND FINDINGS: We analysed 1,930 K. pneumoniae neonate blood isolates from 13 surveillance studies across 35 sites in 13 countries. We used pathogen whole-genome sequencing to predict K and O serotypes and adjust for local transmission clusters, and Bayesian hierarchical meta-analysis to estimate K and O prevalence overall and per region, treating site as a random effect. Eighty-seven K loci were identified. KL2, KL102, KL25, KL15, and KL62 accounted for 49% of isolates. We estimate that 20 K loci, combining the eight most prevalent per region, could cover 72.9% of all infections (95% credible interval: [69.4%, 76.5%]) and ≥70% in each of Eastern, Western, and Southern Africa and South Asia. Preliminary findings from three sites suggested sufficie...