Resurgence of pneumococcal meningitis in Europe and Northern America

D. L. H. Koelman, M. C. Brouwer, D. van de Beek

Research output: Contribution to journalReview articleAcademicpeer-review

42 Citations (Scopus)

Abstract

Background: Streptococcus pneumoniae is the most common pathogen causing bacterial meningitis. The routine use of multivalent conjugate pneumococcal vaccines has led to a decline of invasive pneumococcal disease caused by serotypes included in the vaccine serotypes. Recently, several reports have described a concomitant rise in the incidence of non-vaccine serotypes, suggesting serotype replacement. Objective: We aim to review the effect of pneumococcal vaccination on the incidence of pneumococcal meningitis in Europe and northern America with a particular interest in serotype replacement. Sources: Articles that include data on invasive pneumococcal disease incidence before and after the introduction of vaccination, or on invasive pneumococcal serotype, are discussed, with a focus on pneumococcal meningitis. Content: The introduction of pneumococcal conjugate vaccines has universally resulted in a decline in vaccine-serotype pneumococcal meningitis incidence throughout Europe and northern America. Serotype replacement by non-vaccine serotypes has however been reported following the introduction of the 7-, 10- and 13-valent pneumococcal conjugate vaccines, which in several regions abolished the overall effect of vaccination on pneumococcal meningitis incidence. Implications: The promising decline in the incidence of pneumococcal meningitis following the introduction of vaccination seems to have been temporary. Replacement by non-vaccine serotypes illustrates that pneumococcal meningitis continues to pose a major challenge. We need new approaches to prevention, new vaccines and continued efforts to improve treatment for patients with pneumococcal meningitis.
Original languageEnglish
Pages (from-to)199-204
JournalClinical Microbiology and Infection
Volume26
Issue number2
DOIs
Publication statusPublished - Feb 2020

Keywords

  • incidence
  • invasive pneumococcal disease
  • pneumococcal conjugate vaccine
  • pneumococcal meningitis
  • pneumococcal vaccination
  • serotype distribution
  • serotype replacement

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