BACKGROUND: The impact of pneumococcal conjugate vaccines (PCVs) on the burden of invasive pneumococcal disease (IPD) and serotype distribution was examined across age groups from data collected by the Lebanese Inter-Hospital Pneumococcal Surveillance Program. METHODS: Between 2005 and 2020, 593 invasive Streptococcus pneumoniae isolates were collected from 79 hospitals throughout Lebanon. Serotypes and antimicrobial resistance (AMR) profiles were identified, and trends compared over 3 eras: PCV7, post-PCV7/ pre-PCV13, and PCV13 eras. RESULTS: The prevalence of PCV7 serotypes decreased significantly from 43.6% in the PCV7 era to 17.8% during the PCV13 era (p<0.001). PCV13-only serotypes remained stable in the PCV13 compared to the post-PCV7 eras, especially serotypes 1 and 3, whereas non-vaccine types (NVT) increased throughout the study period, especially 24 and 16F. The mortality rate increased substantially from 12.5% (PCV7 era) to 24.8% (PCV13 era). A significant decrease in AMR was observed across the three study eras. CONCLUSION: PCVs substantially impacted IPD and AMR in vaccinated and unvaccinated populations despite an increase in mortality driven by NVT. Broadening the recommendation of vaccination to include older age-groups, using higher valency vaccines, and implementing stringent antimicrobial stewardship are likely to further impact the burden of IPD.

Biomedical Center Faculty of Medicine Charles University Pilsen Czech Republic

Center for Infectious Diseases Research and WHO Collaborating Center for Reference and Research on Bacterial Pathogens American University of Beirut Beirut Lebanon

Department of Clinical Microbiology and Infection Prevention College of Medicine Central Michigan University and Michigan Health Clinic Michigan USA

Department of Clinical Pathology and Blood Bank Sacre Coeur Hospital Lebanese University Mount Lebanon Lebanon

Department of Experimental Pathology Immunology and Microbiology Faculty of Medicine American University of Beirut Beirut Lebanon

Department of Internal Medicine Division of Infectious Diseases Lebanese American of Beirut Medical Center Rizk Hospital Achrafieh Beirut Lebanon

Department of Laboratory Medicine Al Rassoul Al Azam Beirut Lebanon

Department of Laboratory Medicine Bahman Hospital Lebanon

Department of Laboratory Medicine Bellevue Medical Center Mansourieh Lebanon

Department of Laboratory Medicine Centre Hospitalier du Nord Zgharta Lebanon

Department of Laboratory Medicine Dar El Shifa Tripoli Lebanon

Department of Laboratory Medicine Hammoud Hospital University Medical Center Saida Lebanon

Department of Laboratory Medicine Haykal Hospital Tripoli Lebanon

Department of Laboratory Medicine Labib Medical Center Saida Lebanon

Department of Laboratory Medicine Lebanese Hospital Geitaoui University Medical Center Achrafieh Beirut Lebanon

Department of Laboratory Medicine Monla Hospital Tripoli Lebanon

Department of Laboratory Medicine New Mazloum Hospital Tripoli Lebanon

Department of Laboratory Medicine Notre Dame des Secours University Hospital Center Jbeil Mount Lebanon Lebanon

Department of Laboratory Medicine Rafik Hariri University Hospital Beirut Lebanon

Department of Laboratory Medicine Saint Georges Hospital University Medical Center Achrafieh Saida Lebanon

Department of Medical Laboratory Technology Faculty of Health Sciences Beirut Arab University Beirut Lebanon

Department of Microbiology El Youssef Hospital Center Halba Lebanon

Department of Microbiology Faculty of Medicine and University Hospital in Pilsen Charles University Pilsen Czech Republic

Department of Microbiology Nini Hospital Tripoli Lebanon

Department of Pathology and Laboratory Medicine American University of Beirut Medical Center Beirut Lebanon

Department of Pediatrics and Adolescent Medicine American University of Beirut Faculty of Medicine Beirut Lebanon

Department of Pediatrics Makassed General Hospital Beirut Lebanon

Department of Pediatrics Saint Georges Hospital University Medical Center Achrafieh Beirut Lebanon

Department of Public and Ecosystem Health College of Veterinary Medicine Cornell University Ithaca NY USA

Epidemiological Surveillance Unit Ministry of Public Health Beirut Lebanon

General Director Lebanese Ministry of Public Health Beirut Lebanon

Keserwan Medical Center Jounieh Mount Lebanon Lebanon

Laboratory medicine and transfusion medicine department Makassed General Hospital Beirut Lebanon

PHC Department Lebanese Ministry of Public Health Global Health Team of Experts Lebanon

References provided by Crossref.org