{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T15:41:44Z","timestamp":1793115704688,"version":"4.5.0"},"reference-count":44,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-010429 \/ OPP1189065"],"award-info":[{"award-number":["INV-010429 \/ OPP1189065"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Pneumococcal conjugate vaccine (PCV) introduction has reduced pneumococcal meningitis incidence. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project described the serotype distribution of remaining pneumococcal meningitis in countries using PCV10\/13 for least 5\u20137 years with primary series uptake above 70%. The distribution was estimated using a multinomial Dirichlet regression model, stratified by PCV product and age. In PCV10-using sites (N = 8; cases = 1141), PCV10 types caused 5% of cases &lt;5 years of age and 15% among \u22655 years; the top serotypes were 19A, 6C, and 3, together causing 42% of cases &lt;5 years and 37% \u22655 years. In PCV13-using sites (N = 32; cases = 4503), PCV13 types caused 14% in &lt;5 and 26% in \u22655 years; 4% and 13%, respectively, were serotype 3. Among the top serotypes are five (15BC, 8, 12F, 10A, and 22F) included in higher-valency PCVs under evaluation. Other top serotypes (24F, 23B, and 23A) are not in any known investigational product. In countries with mature vaccination programs, the proportion of pneumococcal meningitis caused by vaccine-in-use serotypes is lower (\u226426% across all ages) than pre-PCV (\u226570% in children). Higher-valency PCVs under evaluation target over half of remaining pneumococcal meningitis cases, but questions remain regarding generalizability to the African meningitis belt where additional data are needed.<\/jats:p>","DOI":"10.3390\/microorganisms9040738","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T10:44:01Z","timestamp":1617273841000},"page":"738","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Serotype Distribution of Remaining Pneumococcal Meningitis in the Mature PCV10\/13 Period: Findings from the PSERENADE Project"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0206-7597","authenticated-orcid":false,"given":"Maria","family":"Garcia Quesada","sequence":"first","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyupei","family":"Yang","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2559-2922","authenticated-orcid":false,"given":"Julia","family":"Bennett","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9872-2313","authenticated-orcid":false,"given":"Kyla","family":"Hayford","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Zeger","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Feikin","sequence":"additional","affiliation":[{"name":"Independent Consultant, 1296 Coppet, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6562-2730","authenticated-orcid":false,"given":"Meagan","family":"Peterson","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Cohen","sequence":"additional","affiliation":[{"name":"World Health Organization, 1202 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samanta","family":"Almeida","sequence":"additional","affiliation":[{"name":"Center of Bacteriology, National Laboratory for Meningitis and Pneumococcal Infections, Institute Adolfo Lutz (IAL), S\u00e3o Paulo 01246-902, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krow","family":"Ampofo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Ang","sequence":"additional","affiliation":[{"name":"National Centre for Infectious Diseases, National Public Health Laboratory, Singapore 308442, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naor","family":"Bar-Zeev","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA"},{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme, P.O. 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