The observational and descriptive study was conducted between September 2018 and October 2019 in healthy children aged between two and 59 months and adults living in the same household. The goal was to determine pneumococcal carriage rates, serotype distribution, and antimicrobial resistance profiles following the introduction of pneumococcal conjugate vaccines (PCV).
The findings reveal worrying trends in the epidemiology of S. pneumoniae in Paraguay, including the persistence of vaccine-type serotypes among vaccinated children and increasing resistance to antibiotics in isolated strains.
The results indicate a higher pneumococcal carriage rate in children than in adults (39% compared with 20%). Intrafamilial transmission remains limited. The study emphasizes that vaccine serotypes continue to circulate despite vaccination, with almost 11% of vaccinated children still carrying these serotypes. The results also highlight an increase in non-vaccine serotypes, accompanied by a rise in resistance to beta-lactams and macrolides. Nearly a third of isolates are multi-drug resistant.
The study carried out within the GABRIEL network calls on public health authorities to integrate this type of research into their strategies for monitoring the impact of the PCV vaccine in low and middle-income countries, given how essential it is in vaccine-preventable disease surveillance.
Streptococcus pneumoniae infections, including pneumonia and meningitis, remain a major cause of morbidity and mortality, especially in low and middle-income countries, where study data remains limited or poorly characterized in contrast to high-income countries.
The study was possible thanks to funding from the Mérieux Foundation, which coordinates the GABRIEL network, and the Research Institute for Health Sciences in Paraguay (Instituto de Investigaciones de Ciencias de la Salud, Asuncion, Paraguay).