(276) Pneumococcal Serotype Distribution: Data in Pediatric Populations Under 5 Years Around the World, 2011–2021

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1321

Presenting Author(s)

Nicole Cossrow
– Merck & Co., Inc., North Wales, Pennsylvania, United States

Co-Author(s)

Rennie Joshi, PhD, MPH
– Associate Scientist, Postdoctoral Fellow, Epidemiology, Merck Sharp & Dohme Corp., BRYN MAWR, PA, United States
Henok Ayele
– Merck, West Point, PA, United States
Danielle Badgley
– Certara, Inc., Canada
Hanane Khoury
– Certara, Inc., QC, Canada
PATRICIA SADDIER, MD, PhD
– Executive Director, Pharmacoepidemiology, Epidemiology, Merck Sharp & Dohme Corp., West Point, PA, United States

Background: Pneumococcal disease (PD), including invasive pneumococcal disease (IPD), is caused by infection with Streptococcus pneumoniae. Despite availability and uptake of pneumococcal conjugate vaccine (PCV) and corresponding decrease in disease, PD, including IPD, remains a global health problem. Emergence of non-vaccine serotypes contributes to the burden of PD.

Objectives: As part of an ongoing program, we performed a systematic literature review to inform changes in serotype distribution globally.

Methods: Medline, EMBASE and Cochrane databases were searched from March 2015 to May 2021 to identify real-world studies from all geographic regions. Serotype distribution data for children < 5 years were extracted and summarized. Serotype prevalence was calculated from pooled data and reported as the proportion of the total number of isolates summarized globally, by region and by disease type.

Results: Serotype data were available in 189 articles covering varying periods from 2011
onwards, including 94,909 isolates. Nearly one-third (31.7%) of articles reported data from
Europe, 28.0% from Asia Pacific, 28.0% from Africa/Eastern Mediterranean, 9.0% from North America and 4.8% from Latin America. The majority (149 publications) were from areas/periods where pediatric PCV has been introduced. Most papers (101) covered nasopharyngeal carriage, 84 covered IPD, 6 covered acute otitis media (AOM) and 1 covered non-invasive pneumonia; 6 reported on IPD and non-IPD combined. Overall, PCV13 and non-PCV serotypes accounted for 28.8% and 34.6% of serotyped isolates, respectively; the remaining isolates were reported as mixtures, ‘other’ or untypeable. Seven of the 10 most prevalent serotypes were PCV13-specific. Globally, the most prevalent non-PCV serotypes were 15B/C (5.3%), 11A (2.8%), 23B (2.4%), 10A (2.2%), 15A (1.8%), 35B (1.7%), 12F (1.5%), 16F (1.5%) and 23A (1.5%). The most common
non-PCV serotypes were 15B/C, 23B, 11A, 12F, 10A in Europe; 15B/C, 15A, 23A, 35B, 11A in Asia Pacific; 15B/C, 10A, 13, 16F, 35B in Africa/Eastern Mediterranean; 15B/C, 22F, 35B, 33F, 11A in North America; 6C, 11A, 23B, 15A, 15B/C, 10A in Latin America. Globally, non-PCV serotypes accounted for 31.6% of IPD isolates, 11.7% of non-invasive pneumonia isolates, 31.1% of AOM isolates and 37.2% of nasopharyngeal carriage isolates.

Conclusions: Pneumococcal disease in children due to PCV serotypes remains a significant burden even in countries using PCV. Furthermore, additional non-PCV serotypes that contribute to PD burden are emerging. Monitoring changing patterns in serotypes associated with disease is critical to support development of newer, effective vaccines.