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Background <p>Streptococcus pneumoniae (SP) remains the leading bacterial cause of lower-respiratory infections (LRIs) in young children, yet longitudinal, resistance-stratified burden estimates to guide global policy are lacking.</p> Objectives <p>To quantify the global burden, temporal trends, and antibiotic resistance (AR) profile of SP-LRIs in children under 5 from 1990 to 2021 and project outcomes to 2030.</p> Methods <p>Using GBD 2021 data, we extracted deaths, Disability-Adjusted Life Years (DALYs) and age-standardized rates (ASRs) for SP-LRIs and eight pathogen–drug resistance pairs in children under 5; trends and 2030 projections were computed at the global level.</p> Results <p>From 1990 to 2021, SP remained the leading contributor to the disease burden. Both the number of cases and ASRs showed a consistently declining trend. The disease burden was inversely correlated with the socio-demographic index (SDI) and age, and was more severe in males. In 2021, the AR burden was severe, approximately four times higher than that of antibiotic-sensitive strains. Resistance to one or more antimicrobial classes was the primary driver of this burden, with cases particularly concentrated in Southeast Asia, East Asia, and Africa. Furthermore, projections indicated that although the disease burden is projected to decline significantly over the next decade, and it will still remain the highest level among the younger age group.</p> Conclusions <p>Despite substantial progress in reducing the disease burden between 1990 and 2021, SP remains the leading pathogen, particularly in low-SDI settings, in young infants, and in high-AR environments.</p>

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Trends in Streptococcus pneumoniae related lower respiratory infections and drug resistance among children under 5 from 1990 to 2021, and a predictive analysis for 2030

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Xiaoxia Liu,
  • Guangyan Mo,
  • Huijing Sun,
  • Sitong Guo,
  • Xiaoyu Chen,
  • Yanni Lan

摘要

Background

Streptococcus pneumoniae (SP) remains the leading bacterial cause of lower-respiratory infections (LRIs) in young children, yet longitudinal, resistance-stratified burden estimates to guide global policy are lacking.

Objectives

To quantify the global burden, temporal trends, and antibiotic resistance (AR) profile of SP-LRIs in children under 5 from 1990 to 2021 and project outcomes to 2030.

Methods

Using GBD 2021 data, we extracted deaths, Disability-Adjusted Life Years (DALYs) and age-standardized rates (ASRs) for SP-LRIs and eight pathogen–drug resistance pairs in children under 5; trends and 2030 projections were computed at the global level.

Results

From 1990 to 2021, SP remained the leading contributor to the disease burden. Both the number of cases and ASRs showed a consistently declining trend. The disease burden was inversely correlated with the socio-demographic index (SDI) and age, and was more severe in males. In 2021, the AR burden was severe, approximately four times higher than that of antibiotic-sensitive strains. Resistance to one or more antimicrobial classes was the primary driver of this burden, with cases particularly concentrated in Southeast Asia, East Asia, and Africa. Furthermore, projections indicated that although the disease burden is projected to decline significantly over the next decade, and it will still remain the highest level among the younger age group.

Conclusions

Despite substantial progress in reducing the disease burden between 1990 and 2021, SP remains the leading pathogen, particularly in low-SDI settings, in young infants, and in high-AR environments.