Serotype distribution of invasive, non-invasive and carried Streptococcus pneumoniae in Malaysia: a meta-analysis

Abstract

Background Pneumococcal pneumonia is the leading cause of under-five mortality globally. The surveillance of pneumococcal serotypes is therefore vital for informing pneumococcal vaccination policy and programmes. Pneumococcal conjugate vaccines (PCVs) have been available as an option in the private healthcare setting and beginning December 2020, PCV10 was incorporated as part of routine national immunisation programme (NIP) in Malaysia. We searched existing literature on pneumococcal serotype distribution across Malaysia to provide an overall view of this distribution before the implementation of PCV10. Methods Online databases (PubMed, Ovid MEDLINE and Scopus), reference lists of articles identified, and grey literature (Malaysian Ministry of Health website, WHO website) were systematically searched for relevant literature on pneumococcal serotype distribution across Malaysia up to 10th November 2020. No lower date limit was set to maximise the number of target reports returned. Results of serotypes were split by age categories, including ≤5 years, > 5 years and unreported for those that did not specify. Results The search returned 18 relevant results, with a total of 2040 isolates. The most common serotypes across all disease types were 19F (n = 313, 15.3% [95%CI: 13.8–17.0]), 23F (n = 166, 8.1% [95%CI: 7.0–9.4]), 14 (n = 166, 8.1% [95%CI: 7.0–9.4]), 6B (n = 163, 8.0% [95%CI: 6.9–9.2]) and 19A (n = 138, 6.8% [95%CI: 5.8–7.9]). Conclusion Four of the most common serotypes across all isolate sources in Malaysia are covered by PCV10, while PCV13 provides greater serotype coverage in comparison to PCV10. There is still a need for surveillance studies, particularly those investigating serotypes in children under 5 years of age, to monitor vaccine effectiveness and pneumococcal population dynamic following implementation of PCV10 into routine immunisation.

Pneumococcal nasopharyngeal carriage in children under 5 years of age at an outpatient healthcare facility in Novi Sad, Serbia during the COVID-19 pandemic

“…Seven of the nine leading serotypes (6B, 19F, 11A, 6C, 23F, 3 and 19A) were significantly more prevalent in unvaccinated children aged 36–60 months compared with those aged 24–35 months, and all leading serotypes were significantly more prevalent among fully vaccinated children aged 24–35 months. Serotype 19A represented only 3.5% of all detected S. pneumoniae isolates, and its prevalence has not yet increased, unlike in many countries following PCV7 or PCV10 implementation where it emerged as one of the most prevalent serotypes in the post-vaccination era ( McIntosh and Reinert, 2011 ; Cui et al., 2017 ; Lister et al., 2021 ).…”

PfaSTer: a machine learning-powered serotype caller for Streptococcus pneumoniae genomes

“…As a result, PfaSTer prediction is limited to 65 types due to a shortage of available genomes for such rare serotypes. From recent studies, commonly collected serotypes shared across the USA, Europe and Asia include 1, 3, 6A, 6B, 14, 18C, 19F and 23F, with other serotypes identified at a lower frequency [30][31][32][33][34]. These prevalent serotypes are all included in the PCV formulations of PCV13 [35] and PCV20 [9].…”

PfaSTer: A ML-powered serotype caller forStreptococcus pneumoniaegenomes

“…As a result, PfaSTer prediction is limited to 65 types due to a shortage of available genomes for rare serotypes. From recent studies, commonly collected serotypes shared across the US, Europe, and Asia include 1, 3, 6A, 6B, 14, 18C, 19F, and 23F, with other serotypes identified at lower frequency [27][28][29][30][31]. Unsurprisingly, these prevalent serotypes are all included in the pneumococcal conjugate vaccine (PCV) formulations of PCV13 [32] and PCV20 [8].…”