{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T09:15:24Z","timestamp":1778145324763,"version":"3.51.4"},"reference-count":94,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pfizer Pharmaceuticals, USA","award":["56833225"],"award-info":[{"award-number":["56833225"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background: Streptococcus pneumoniae, also referred to as pneumococcus, is of immense public health significance. In particular, it causes severe invasive diseases among children. This has led to the recommendation of anti-pneumococcal prophylaxis, including the administration of penicillin and pneumococcal conjugate vaccines (PCVs), which have become available in about 90% of the countries in sub-Saharan Africa. Nonetheless, breakthrough disease still occurs. Also, PCVs can cause a shift in the distribution of pneumococcal serotypes, usually towards non-vaccine types. However, in many sub-Saharan African countries where PCVs have been introduced, there are hardly any comprehensive post-vaccination surveillance data on pneumococcus. Aim: To describe the post-vaccination epidemiology of invasive pneumococcal disease (IPD) in Ghana, including the prevalence, serotype distribution and antibiotic resistance. Methods: The study was cross-sectional and involved 14,597 patients recruited at the Korle Bu Teaching Hospital, Greater Accra Regional Hospital, Princess Marie Louise Children\u2019s Hospital, Ho Regional Hospital, Eastern Regional Hospital, and Zonal Public Health and Reference Laboratory, Tamale. Specimens of cerebrospinal fluid (obtained by lumbar puncture) and blood were collected routinely from meningitis patients, while blood specimens were taken from pneumonia patients. These were cultured for S. pneumoniae following standard microbiological methods and subjected to antimicrobial susceptibility testing. The isolates were serotyped by the pneumotest latex agglutination kit, and the results confirmed by Quellung reaction, using serotype-specific antisera. Results: The overall prevalence of IPD was 0.66% (n = 97), varying across syndromes: bloodstream infections (0.53%, n = 38), meningitis (2.45%, n = 43), and pneumonia (0.28%, n = 16). The majority of the cases (56.70%, n = 55) occurred in the 11\u201320-year-old group. Ten pneumococcal serotypes were identified, with Serotype 1 being predominant (58.76%), followed by Serotypes 23B (11.34%), 33F (9.28%), and 12F (8.24%). Vaccine serotypes accounted for 81.44% of the isolates, while 18.56% were non-vaccine serotypes (23A, 23B, and 38). Antimicrobial resistance was highest against sulphamethoxazole-trimethoprim (52%), ampicillin (51%), and penicillin (46%). No resistance was observed against ciprofloxacin, levofloxacin, and vancomycin. The multidrug resistance proportion was 42.3% (n = 41). Conclusions: Even in the post-vaccination era, vaccine-type IPD remains a significant public health issue in Ghana. The observed serotype distribution and antimicrobial resistance patterns warrant sustained surveillance, more adaptive vaccination policies, and rigorous antibiotic stewardship to effectively mitigate IPD burden.<\/jats:p>","DOI":"10.3390\/diseases14050162","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T08:01:39Z","timestamp":1778140899000},"page":"162","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-Vaccination Surveillance of Invasive Pneumococcal Disease in Ghana"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0286-3638","authenticated-orcid":false,"given":"Fleischer C. N.","family":"Kotey","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5726-4694","authenticated-orcid":false,"given":"Reuben E.","family":"Arhin","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana"},{"name":"Department of Science Laboratory Technology, Accra Technical University, Accra P.O. Box GP 561, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4491-6902","authenticated-orcid":false,"given":"Nicholas T. K. D.","family":"Dayie","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel O.","family":"Ampah","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana"},{"name":"Greater Accra Regional Hospital, Accra P.O. Box 473, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abass","family":"Abdul-Karim","sequence":"additional","affiliation":[{"name":"Zonal Public Health and Reference Laboratory, Tamale P.O. Box TL 99, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deric A.","family":"Baah","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth M.","family":"Afful","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana"},{"name":"Korle Bu Teaching Hospital, Korle Bu, Accra P.O. Box KB 77, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgina","family":"Tetteh-Ocloo","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana"},{"name":"Eastern Regional Hospital, Koforidua P.O. Box KF 175, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland T.","family":"Kom-Zuta","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana"},{"name":"Eastern Regional Hospital, Koforidua P.O. Box KF 175, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9522-8320","authenticated-orcid":false,"given":"Francis K. M.","family":"Tetteh","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana"},{"name":"Pathology Division, 37 Military Hospital, Neghelli Barracks, Accra P.O. Box 121, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2216-7237","authenticated-orcid":false,"given":"Mary-Magdalene","family":"Osei","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne N. A.","family":"Brew","sequence":"additional","affiliation":[{"name":"Greater Accra Regional Hospital, Accra P.O. Box 473, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mame Y.","family":"Nyarko","sequence":"additional","affiliation":[{"name":"Princess Marie Louise Children\u2019s Hospital, Accra P.O. Box GP 122, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karikari","family":"Asafo-Adjei","sequence":"additional","affiliation":[{"name":"Ho Regional Hospital, Ho P.O. Box MA 374, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3344-4869","authenticated-orcid":false,"given":"Patience B.","family":"Tetteh-Quarcoo","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edem M. A.","family":"Tette","sequence":"additional","affiliation":[{"name":"Department of Community Health, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric S.","family":"Donkor","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/S0140-6736(09)61204-6","article-title":"Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: Global estimates","volume":"374","author":"Wolfson","year":"2009","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e744","DOI":"10.1016\/S2214-109X(18)30247-X","article-title":"Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: Global, regional, and national estimates for 2000-15","volume":"6","author":"Wahl","year":"2018","journal-title":"Lancet Glob. 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