Title:A Systematic Review and Meta-Analysis of Serotype Distribution of Streptococcus Pneumoniae in Iran: Practical Evidence to Optimizing Local Vaccination Protocols
Volume: 21
Issue: 2
Author(s): Abdollah Karimi, Seyedeh Mahsan Hoseini-Alfatemi and Sedigheh Rafiei Tabatabaei*
Affiliation:
- Pediatric Infections Research Center, Research Institute for Children̍s Health, Shahid Beheshti University of Medical Sciences, Tehran,Iran
Keywords:
Streptococcus pneumoniae, polysaccharide capsule, serotype, vaccine, pneumococcal, invasive diseases.
Abstract: Background: Little is known regarding the burden of predominant circulating serotypes
of Streptococcus pneumoniae in Iran. Therefore, this study aimed to investigate the serotype distribution
of pneumococcal diseases in Iran by using a comprehensive systematic review of available
articles.
Methods: A systematic literature search was carried out to identify papers published by Iranian authors
in the Web of Science, PubMed, Scopus, Embase and Google Scholar electronic databases
from January 2000 to December 2018. Then, eight publications that met our inclusion criteria were
selected for data extraction and analysis by Comprehensive Meta-Analysis software.
Results: In total, three studies reported the distribution of S. pneumoniae serotypes among patients,
two studies among healthy individuals, and three studies among both groups. Of those studies, serotype
19A/F (17.9%; 95% CI: 13.6-23.0) was the most circulating serotype followed by 23A/F
(12.3%; 95% CI: 7.7-19.2), 6A/B (11.0%; 95% CI: 8.0-14.9), and 14 (8.8%; 95% CI: 5.8-13.2). In
contrast, the lowest circulating serotype was 60 (0.02%; 95% CI: 0.0-1.2), 29 (0.07%; 95% CI:
0.01-5.0), and 36 (0.09%; 95% CI: 0.04-2.1). Meta-regression results showed that prevalence of
serotype 23A/F significantly increased each year about 0.2% (95% CI: 0.1-0.3, P <0.001, tau2
<0.001).
Conclusion: In the present study, it was found that over the last decade, the most prevalent serotypes
in Iran were 19, 23, 6, and 14, respectively. These findings provide practical evidence to select
effective pneumococcal vaccine candidates for the prevention of invasive diseases in Iranian
patients and also to compare our situation with others.
