Background Despite the availability of vaccines, invasive bacterial diseases remain a public health concern and cause childhood morbidity and mortality. We investigated the characteristics of etiological agents causing bacterial meningitis in children <5 years in the years pre- (2010–2012) and post- (2014–2019) 10-valent pneumococcal conjugate vaccine (PCV10) introduction in Zambia. Methods Streptococcus pneumoniae (Spn), Haemophilus influenzae (Hi), and Neisseria meningitidis (Nm) from cerebrospinal fluid (CSF) were identified by microbiological culture and/or real-time polymerase chain reaction. Results During the surveillance period, a total of 3811 children were admitted with suspected meningitis, 16% (598 of 3811) of which were probable cases. Bacterial meningitis was confirmed in 37% (221 of 598) of the probable cases. Spn pneumoniae, Hi, and Nm accounted for 67% (148 of 221), 14% (31 of 221), and 19% (42 of 221) of confirmed cases, respectively. Thirty-six percent of pneumococcal meningitis was caused by 10-valent pneumococcal conjugate vaccine (PCV10) serotypes, 16% 13-valent pneumococcal conjugate vaccine and 39% by nonvaccine serotype (NVS). There was an association between the introduction of PCV10 vaccination and a decrease in both Spn meningitis and the proportion of PVC10 serotypes in the postvaccination period. Antimicrobial susceptibility of 47 Spn isolates revealed 34% (16 of 47) penicillin resistance. The 31 serotyped Hi accounted for 74% type b (Hib) and 10% type a (Hia). All 42 serogrouped Nm belonged to serogroup W. Conclusions There was a decline in pneumococcal meningitis and proportion of PCV10 serotypes in the postvaccination period. However, the serotype replacement with non-PCV10 serotypes and penicillin resistance warrant continued surveillance to inform policy.

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2010-2019 年赞比亚卢萨卡因脑膜炎住院的 5 岁以下儿童的侵袭性细菌性疾病负担和 10 价肺炎球菌结合疫苗的影响

背景 尽管有疫苗可用，侵袭性细菌性疾病仍然是一个公共卫生问题，并导致儿童发病率和死亡率。我们调查了在赞比亚引入 10 价肺炎球菌结合疫苗 (PCV10) 之前（2010-2012 年）和之后（2014-2019 年）的 5 岁以下儿童中引起细菌性脑膜炎的病原体的特征。方法通过微生物培养和/或实时聚合酶链反应从脑脊液（CSF）中鉴定肺炎链球菌（Spn）、流感嗜血杆菌（Hi）和脑膜炎奈瑟菌（Nm）。结果 在监测期间，共有 3811 名疑似脑膜炎儿童入院，其中 16%（3811 名中的 598 名）为疑似病例。37%（598 例中的 221 例）确诊为细菌性脑膜炎。肺炎链球菌，嗨，和 Nm 分别占确诊病例的 67%（221 例中的 148 例）、14%（221 例中的 31 例）和 19%（221 例中的 42 例）。36% 的肺炎球菌脑膜炎由 10 价肺炎球菌结合疫苗 (PCV10) 血清型引起，16% 由 13 价肺炎球菌结合疫苗引起，39% 由非疫苗血清型 (NVS) 引起。PCV10 疫苗接种的引入与 Spn 脑膜炎和疫苗接种后阶段 PVC10 血清型比例的降低之间存在关联。47 个 Spn 分离株的抗菌药物敏感性显示 34%（47 个中的 16 个）青霉素耐药性。31 种血清型 Hi 占 b 型 (Hib) 的 74% 和 a 型 (Hia) 的 10%。42个血清群Nm均属于血清群W。结论接种后肺炎球菌性脑膜炎发病率和PCV10血清型比例均有所下降。然而，