{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T23:06:55Z","timestamp":1780960015041,"version":"3.54.1"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      acquiring multidrug resistance globally, which poses a threat to the effective treatment of respiratory infections. This systematic review and meta\u2010analysis aimed to evaluate global and regional antimicrobial susceptibility patterns of\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>S. pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      respiratory isolates collected between 2015 and 2024.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Scopus, PubMed and Web of Science were searched from January 2015 to December 2024 following PRISMA guidelines. Inclusion criteria comprised English\u2010language original studies reporting antibiotic susceptibility rates of\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>S. pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      isolated from respiratory samples of human origin, while studies with fewer than 10 isolates or lacking clear specification of sample type were excluded. Participants were respiratory samples yielding\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>S. pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      from human subjects across six WHO\u2010defined regions. No interventions were applied, as this was an observational synthesis of surveillance and observational studies. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. A random\u2010effects model with double arcsine transformation was applied to pool susceptibility proportions, and subgroup analyses were conducted by geographical region.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010three studies comprising 20,768 isolates were included. Overall susceptibility rates were highest for linezolid (100%) and vancomycin (99%). Penicillin susceptibility was 77% (95% CI: 65\u201388), but markedly lower in the African (61%) and Eastern Mediterranean (26%) regions. Erythromycin (35%) and tetracycline (42%) susceptibility showed significant declines in the Western Pacific region (3% and 11%, respectively). Trimethoprim\u2010sulfamethoxazole (48%) and clindamycin (60%) also displayed regional variability. Sensitivity analyses restricted to low\u2010risk studies confirmed the robustness of findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Antimicrobial susceptibility of\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>S. pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      respiratory isolates varies substantially by region. These results support the importance of regional antibiotic stewardship strategies and updated treatment guidelines to address declining susceptibility and emerging resistance patterns.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.70106","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T08:20:53Z","timestamp":1771402853000},"page":"612-622","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of Antimicrobial Susceptibility Patterns of\n                    <scp>\n                      <i>Streptococcus pneumoniae<\/i>\n                    <\/scp>\n                    Respiratory Isolates: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6423-9609","authenticated-orcid":false,"given":"Abdulhamit","family":"Cali","sequence":"first","affiliation":[{"name":"Medical Laboratory Techniques, Vocational School of Health Services Lokman Hekim University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5843-626X","authenticated-orcid":false,"given":"Rukiye","family":"Aslan","sequence":"additional","affiliation":[{"name":"Pharmaceutical Microbiology, Department of Basic Pharmaceutical Sciences, Faculty of Pharmacy Sivas Cumhuriyet University  Sivas Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7141-5874","authenticated-orcid":false,"given":"Cem","family":"Celik","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine Sivas Cumhuriyet University  Sivas Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010024\u201072"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-802823-0.00015-8"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms11010070"},{"key":"e_1_2_12_5_1","first-page":"85","article-title":"Pneumococcal Conjugate Vaccines in Infants and Children Under 5\u2009Years of Age: WHO Position Paper\u2014February 2019","volume":"94","author":"World Health Organization (WHO)","year":"2019","journal-title":"Weekly Epidemiological Record"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens12060780"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.14138"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1214\/aoms\/1177729756"},{"key":"e_1_2_12_10_1","unstructured":"J.\u2010H.Jeong \u201cDomain of Inverse Double Arcsine Transformation \u201dpreprint arXiv 2018 https:\/\/arXiv.org.abs\/1811.07827."},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/00031305.1978.10479283"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010021\u201001381\u2010z"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d549"},{"key":"e_1_2_12_14_1","volume-title":"Cochrane Statistical Methods Group, Statistical Methods Training for Statisticians Supporting CRGs","author":"Higgins J.","year":"2016"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000054"},{"key":"e_1_2_12_16_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 6.5 Update","author":"Deeks J. 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