Pneumococcal meningitis in Mexico. Serotype distribution and antimicrobial resistance before and after the introduction of pneumococcal conjugate vaccines in pediatric patients. Results from the GIVEBPVac group.
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История · было → стало
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Carnalla-Barajas María Noemí, Soto-Noguerón Araceli, Solórzano-Santos Fortino, Macías-Parra Mercedes, Díaz-Jiménez Virginia, Sánchez-González Gilberto, Jiménez-Juárez Rodolfo, Parra-Ortega Israel, Sánchez-Francia Domingo, Luévanos-Velázquez Antonio, Merlo-Palomera Mariana, Flores-Santos Andrés, Magaña-Aquino Martín, Tinoco-Favila Juan Carlos, Corte-Rojas Reyna Edith, Garza-González Elvira, Guajardo-Lara Claudia Elena, Vázquez-Narváez Jorge Alejandro, Hernández-Magaña Rafael, Sánchez-Reyes Beatriz Adriana, Pacheco-Gil Leova, Monroy-Colín Víctor Antonio, Rincón-Zuno Joaquín, Feliciano-Guzmán José Manuel, Echániz-Aviles Gabriela
Аннотация
METHODS: We conducted a prospective analysis of pneumococcal isolates collected from children aged 0-17 years diagnosed with meningitis between 1993 and 2024 through the GIVEBPVac surveillance network. Serotyping was performed using the Neufeld-Quellung reaction, and AMR profiles were determined by broth microdilution following CLSI guidelines. Temporal trends were assessed by Poisson regression and stratified by vaccination period (pre-PCV, PCV7/PCV10, and PCV13).
RESULTS: A total of 575 pneumococcal meningitis isolates were analyzed. The proportion of PCV13 serotypes declined from 77.2 % in the pre-PCV period to 33.3 % in the PCV13 period, while non-vaccine serotypes rose to 66.7 %. Serotypes 14, 6B, 19 F, and 23 F were predominant before PCV introduction. In the PCV13 era, serotypes 19 A and 15B increased in frequency, while 23B and 6 C emerged among non-vaccine serotypes. Resistance to cefotaxime increased from 22.8 % in the pre-PCV to 30.4 % during the PCV13 period. The overall case fatality rate was 8 %.
CONCLUSION: PCVs significantly reduced the burden of pneumococcal meningitis in Mexican children. However, the emergence of non-vaccine serotypes and the persistence of serotype 19 A highlights the need for continued surveillance and evaluation of higher-valent vaccines to inform future immunization strategies.