Complicated pneumococcal pneumonia in the era of higher-valent pneumococcal conjugate vaccines: a systematic literature review and meta-analysis, 2001-2022

作者：Fletcher MA, Okasha O, Baay M, Syrochkina M, Hayford K · 发表于：European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 年份：2025 · DOI：10.1007/s10096-025-05114-8 · 被引用次数：66 · 研究领域：Pneumococcal Vaccines、Pneumonia, Pneumococcal、Streptococcus pneumoniae、Humans、Incidence、Serogroup、Vaccines, Conjugate

PURPOSE: To estimate pneumococcal conjugate vaccine (PCV) national program impact on pneumococcal complicated pneumonia (PnCP) based on changes in PnCP population-based incidence, PnCP proportion of all-cause complicated pneumonia (or invasive pneumococcal disease), and PnCP serotype distribution. METHODS: MEDLINE, EMBASE, and Global Index Medicus articles (2001-March 2022) reporting laboratory-confirmed PnCP studies were stratified by age group, outcome measure, PCV program period(s) (pre-PCV, transition, and post-PCV), serotype distribution (based on serotyping methodology used), and PCV serotype formulation. Random effect meta-analysis of the total number of serotyped isolates within each study was used to calculate pooled serotype-specific percentages. RESULTS: Of 1360 publications screened, the 134 studies included from 30 countries differed widely by methodological approaches. Pediatric PnCP incidence tended to decline from pre-PCV to post-PCV periods, as did PnCP as a proportion of all-cause complicated pneumonia from transition to post-PCV periods. Studies describing changes in serotype distribution by PCV program period applied detection methods that varied from pre-PCV period microbiological culture with Quellung serotyping to in the transition and post-PCV periods molecular methods like PCR. Meta-analysis revealed near elimination of pediatric PCV7-serotype PnCP between pre- and post-PCV, while the PCV13nonPCV7 percentage increased from 51.1% pre-PCV period to 76...