{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T04:52:36Z","timestamp":1775537556819,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto Nacional de Enfermedades Infecciosas (INEI)\u2014ANLIS \u201cDr. Carlos G. Malbr\u00e1n\u201d"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>The introduction of pneumococcal conjugate vaccination (PCV) into the Argentinian Childhood National Immunization Program in 2012 marked a significant milestone in public health. Our study aims to assess the impact of this intervention on pneumococcal meningitis cases, serotype distribution, and antimicrobial resistance among pediatric populations from 2013 to 2023. Specifically, we compared the early post-PCV period (2013\u20132014) to the late post-PCV period (2022\u20132023). A total of 333 pneumococcal isolates were analyzed between 2013 and 2023. Gold standard pneumococcal serotyping was performed to identify the serotypes associated with infection in children &lt; 6 years in Argentina, and the agar dilution method was carried out to determine their profiles to antimicrobial agents. Our findings underscore the importance of PCV implementation, revealing notable shifts in pneumococcal epidemiology over the study period. The proportions of serotypes 1 (6.7% to 0.0%), 5 (5.6% to 0.0%), and 14 (7.8% to 1.8%) decreased, whereas the proportions of serotypes 10A (3.3% to 10.7%), 15B\/C (2.2% to 10.7%), and 24B (0.0% to 8.9%) increased. The top five rated serotypes in the 2022\u20132023 period were serogroup 24 (21.4%), 10A (10.7%), 15B\/C (10.7%), 23B (7.1%), and 12F (5.4%). Regarding antimicrobial resistance, we found that a total of 115\/311 isolates (37%) were not suceptible to penicillin, and 2.9% were not suceptible to cefotaxime. Twenty-five percent of the isolates were microbial drug resistant, with resistance to penicillin, erythromycin, tetracycline\/doxicycline, and\/or cotrimoxazol. Among the PCV13 serotypes, 19A remained the most commonly associated with MDR. The non-PCV13 serotypes, particularly 24F, 24A, and 24B, were prevalent among MDR isolates. The observed trends demonstrate the need for the continued expansion of pneumococcal vaccination policies, including consideration for vaccines offering enhanced indirect protection, thereby extending benefits beyond the pediatric population to encompass adults as well. Such strategies are pivotal in reducing the burden of pneumococcal disease and safeguarding public health.<\/jats:p>","DOI":"10.3390\/microorganisms13061301","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T06:21:51Z","timestamp":1748931711000},"page":"1301","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evolving Landscape of Paediatric Pneumococcal Meningitis in Argentina (2013\u20132023)"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5442-0586","authenticated-orcid":false,"given":"Jonathan","family":"Zintgraff","sequence":"first","affiliation":[{"name":"Servicio Bacteriolog\u00eda Cl\u00ednica, Departamento de Bacteriolog\u00eda, Instituto Nacional de Enfermedades Infecciosas (INEI)\u2014ANLIS \u201cDr. Carlos G. Malbr\u00e1n\u201d, Buenos Aires C1282AFF, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1551-7208","authenticated-orcid":false,"given":"Paula","family":"Gagetti","sequence":"additional","affiliation":[{"name":"Servicio Antimicrobianos, Departamento de Bacteriolog\u00eda, Instituto Nacional de Enfermedades Infecciosas (INEI)\u2014ANLIS \u201cDr. Carlos G. Malbr\u00e1n\u201d, Buenos Aires C1282AFF, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6842-7292","authenticated-orcid":false,"given":"Nahuel","family":"Sanchez Eluchans","sequence":"additional","affiliation":[{"name":"Servicio Bacteriolog\u00eda Cl\u00ednica, Departamento de Bacteriolog\u00eda, Instituto Nacional de Enfermedades Infecciosas (INEI)\u2014ANLIS \u201cDr. Carlos G. Malbr\u00e1n\u201d, Buenos Aires C1282AFF, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulina","family":"Marchetti","sequence":"additional","affiliation":[{"name":"Servicio Bacteriolog\u00eda Cl\u00ednica, Departamento de Bacteriolog\u00eda, Instituto Nacional de Enfermedades Infecciosas (INEI)\u2014ANLIS \u201cDr. Carlos G. Malbr\u00e1n\u201d, Buenos Aires C1282AFF, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Alicia","family":"Moscoloni","sequence":"additional","affiliation":[{"name":"Servicio Bacteriolog\u00eda Cl\u00ednica, Departamento de Bacteriolog\u00eda, Instituto Nacional de Enfermedades Infecciosas (INEI)\u2014ANLIS \u201cDr. Carlos G. Malbr\u00e1n\u201d, Buenos Aires C1282AFF, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Argentina Spn Working Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7574-1194","authenticated-orcid":false,"given":"Claudia Sara","family":"Lara","sequence":"additional","affiliation":[{"name":"Servicio Bacteriolog\u00eda Cl\u00ednica, Departamento de Bacteriolog\u00eda, Instituto Nacional de Enfermedades Infecciosas (INEI)\u2014ANLIS \u201cDr. Carlos G. Malbr\u00e1n\u201d, Buenos Aires C1282AFF, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1183-6746","authenticated-orcid":false,"given":"Alejandra","family":"Corso","sequence":"additional","affiliation":[{"name":"Servicio Antimicrobianos, Departamento de Bacteriolog\u00eda, Instituto Nacional de Enfermedades Infecciosas (INEI)\u2014ANLIS \u201cDr. Carlos G. Malbr\u00e1n\u201d, Buenos Aires C1282AFF, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1097\/QCO.0000000000000417","article-title":"Epidemiology of community-acquired bacterial meningitis","volume":"31","author":"Brouwer","year":"2018","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Schiess, N., Groce, N.E., and Dua, T. (2021). The Impact and Burden of Neurological Sequelae Following Bacterial Meningitis: A Narrative Review. Microorganisms, 9.","DOI":"10.3390\/microorganisms9050900"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.ijid.2021.04.070","article-title":"World Meningitis Day and the World Health Organization0 s roadmap to defeat bacterial meningitis in the COVID-19 pandemic era","volume":"107","author":"Pinto","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_4","unstructured":"GBD 2016 Meningitis Collaborators (2018). Global, regional, and national burden of meningitis, 1990\u20132016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol., 17, 1061\u20131082."},{"key":"ref_5","unstructured":"GBD 2019 Antimicrobial Resistance Collaborators (2022). Global mortality associated with 33 bacterial pathogens in 2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet, 400, 2221\u20132248."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.1056\/NEJMoa1005384","article-title":"Bacterial meningitis in the United States, 1998\u20132007","volume":"364","author":"Thigpen","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_7","unstructured":"(2025, February 03). Available online: https:\/\/regionsanitaria1.ar\/datosepidemio\/normativas%20y%20tutoriales%20generales\/vigilancia-clinica-de-enos.pdf#:~:text=Nacional%20de%20Vigilancia%20de%20la%20Salud%20(SNVS)%2C,en%20lo%20que%20se%20denomina%20Hoja%20C2."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S352","DOI":"10.1093\/infdis\/jiaa535","article-title":"Triumph of Pneumococcal Conjugate Vaccines: Overcoming a Common Foe","volume":"224","author":"Rodgers","year":"2021","journal-title":"J. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Feemster, K., Hausdorff, W.P., Banniettis, N., Platt, H., Velentgas, P., Esteves-Jaramillo, A., Burton, R.L., Nahm, M.H., and Buchwald, U.K. (2024). Implications of Cross-Reactivity and Cross-Protection for Pneumococcal Vaccine Development. Vaccines, 12.","DOI":"10.3390\/vaccines12090974"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2336358","DOI":"10.1080\/21645515.2024.2336358","article-title":"State of pneumococcal vaccine immunity","volume":"20","author":"Akkoyunlu","year":"2024","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_11","first-page":"498","article-title":"Vacuna anti-Haemophilus influenzae de tipo b (Hib) en el Calendario Nacional de Argentina: Portaci\u00f3n nasofar\u00edngea de Hib tras 8 a\u00f1os de su introducci\u00f3n","volume":"105","author":"Romanin","year":"2007","journal-title":"Arch. Argent. Pediatr."},{"key":"ref_12","unstructured":"World Health Organization (2020). Global Vaccine Action Plan: Defeating Meningitis by 2030 Meningitis Prevention and Control, World Health Organization Seventy-Third World Health Assembly."},{"key":"ref_13","unstructured":"(2025, February 03). Available online: https:\/\/www.argentina.gob.ar\/sites\/default\/files\/2024\/04\/ben_657_se_23.pdf."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1111\/apm.1966.68.3.458","article-title":"Omni-serum Rasmussen P. A diagnostic Pneumococcus serum, reacting with the 82 known types of Pneumococcus","volume":"68","author":"Lund","year":"1966","journal-title":"Acta Pathol. Microbiol. Scand."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.vaccine.2013.08.062","article-title":"Standard method for detecting upper respiratory carriage of Streptococcus pneumoniae: Updated recommendations from the WorldHealth Organization Pneumococcal Carriage Working Group","volume":"32","author":"Satzke","year":"2013","journal-title":"Vaccine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1128\/JCM.02243-09","article-title":"Revisiting pneumococcal carriage by use of broth enrichment and PCR techniques for enhanced detection of carriage and serotypes","volume":"48","author":"Carvalho","year":"2010","journal-title":"J. Clin. Microbiol."},{"key":"ref_17","unstructured":"Merck Sharp & Dohme Corp (2020, December 20). A Phase 3, Multicenter, Randomized, Double-Blind, Active Comparator-Controlled Study to Evaluate the Safety, Tolerability, and Immunogenicity of V114 in Healthy Adults 50 Years of Age or Older (PNEU-AGE), Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03950622."},{"key":"ref_18","unstructured":"Pfizer (2020, December 20). A Phase 3, Randomized, Double-Blind Trial to Evaluate the Safety and Immunogenicity of a 20-Valent Pneumococcal Conjugate Vaccine in Pneumococcal Vaccine-Naive Adults 18 Years of Age and Older, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03760146."},{"key":"ref_19","unstructured":"Skinner, J., Kaufhold, R., and McGuinness, D. (2018, January 15). Immunogenicity of PCV24, a next Generation Pneumococcal Conjugate Vaccine. Proceedings of the 11th International Symposium on Pneumococci and Pneumococcal Diseases, Melbourne, Australia."},{"key":"ref_20","unstructured":"Affinivax (2020, December 10). Affinivax Announces the Presentation of Phase 1 Clinical Data for Its MAPSTM Vaccine for Streptococcus Pneumoniae at IDWeek 2020. Available online: https:\/\/affinivax.com\/press-release-october-21-2020\/."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"6192","DOI":"10.1128\/IAI.71.11.6192-6198.2003","article-title":"Genetic Basis for the Structural Difference between Streptococcus Pneumoniae Serotype 15B and 15C Capsular Polysaccharides","volume":"71","author":"Kolkman","year":"2003","journal-title":"Infect. Immun."},{"key":"ref_22","unstructured":"CLSI (2023). Performance Standards for Antimicrobial Susceptibility Testing, CLSI Supplement M100; Clinical and Laboratory Standards Institute. [33rd ed.]."},{"key":"ref_23","unstructured":"CLSI (2012). Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically M07-A9, Clinical and Laboratory Standards Institute. [9th ed.]."},{"key":"ref_24","unstructured":"The European Committee on Antimicrobial Susceptibility Testing (2025, February 03). Breakpoint Tables for Interpretation of MICs and Zone Diameters. Version 14.0. Available online: http:\/\/www.eucast.org."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1093\/cid\/ciaa614","article-title":"Declines in Pneumonia Mortality Following the Introduction of Pneumococcal Conjugate Vaccines in Latin American and Caribbean Countries","volume":"73","author":"Shioda","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1093\/cid\/cix850","article-title":"Impact of Pneumococcal Vaccination on Pneumonia Hospitalizations and Related Costs in Ontario: A Population-Based Ecological Study","volume":"66","author":"Luca","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.ijid.2021.02.031","article-title":"Burden of invasive pneumococcal disease (IPD) over a 10-year period in Bogot\u00e1, Colombia","volume":"105","author":"Bastidas","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"7107","DOI":"10.1016\/j.vaccine.2017.10.090","article-title":"Impact of infant pneumococcal conjugate vaccination on community acquired pneumonia hospitalization in all ages in the Netherlands","volume":"35","author":"Man","year":"2017","journal-title":"Vaccine"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1177\/000992289603500204","article-title":"Long-term sequelae of pneumococcal meningitis in children","volume":"35","author":"Pikis","year":"1996","journal-title":"Clin. Pediatr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"263","DOI":"10.3233\/JPI-2010-0261","article-title":"Surveillance of invasive in Streptococcus pneumoniae in Argentina 1994\u20132007: Changes in serotype distribution, serotype coverage of pneumococcal conjugate vaccines and antibiotic resistance","volume":"5","author":"Ruvinsky","year":"2010","journal-title":"J. Pediatr. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Garcia Quesada, M., Yang, Y., Bennett, J.C., Hayford, K., Zeger, S.L., Feikin, D.R., Peterson, M.E., Cohen, A.L., Almeida, S.C.G., and Ampofo, K. (2021). Serotype Distribution of Remaining Pneumococcal Meningitis in the Mature PCV10\/13 Period: Findings from the PSERENADE Project. Microorganisms, 9.","DOI":"10.3390\/microorganisms9040738"},{"key":"ref_33","unstructured":"(2025, February 03). Available online: https:\/\/www.argentina.gob.ar\/salud\/inmunoprevenibles\/coberturas-de-vacunacion."},{"key":"ref_34","unstructured":"(2025, February 03). Available online: https:\/\/www.argentina.gob.ar\/sites\/default\/files\/2019\/05\/2024_08_26-cnv_2023-cierre-agosto-2024.pdf."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Lodi, L., Ricci, S., Nieddu, F., Moriondo, M., Lippi, F., Canessa, C., Mangone, G., Cortimiglia, M., Casini, A., and Lucenteforte, E. (2019). Impact of the 13-Valent Pneumococcal Conjugate Vaccine on Severe Invasive Disease Caused by Serotype 3 Streptococcus pneumoniae in Italian Children. Vaccines, 7.","DOI":"10.3390\/vaccines7040128"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2135","DOI":"10.1093\/cid\/ciy920","article-title":"Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine Against Invasive Disease Caused by Serotype 3 in Children: A Systematic Review and Meta-Analysis of Observational Studies","volume":"68","author":"Gessner","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_37","unstructured":"(2025, February 03). Available online: https:\/\/www.argentina.gob.ar\/sites\/default\/files\/2018\/02\/lineamiento_tecnico_vcn20_2024.pdf."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/6\/1301\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:46:32Z","timestamp":1760031992000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/6\/1301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,3]]},"references-count":37,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["microorganisms13061301"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms13061301","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,3]]}}}