Distribution of capsule and O types in Klebsiella pneumoniae causing neonatal sepsis in Africa and South Asia: A meta-analysis of genome-predicted serotype prevalence to inform potential vaccine coverage
Neonatal sepsis is associated with diverse K and O types, with substantial geographic and temporal variation even after adjusting for localised transmission clusters. Despite this, a single 20-valent K vaccine could theoretically cover ≥70% of infections in all target regions. Locally-targeted vaccines could achieve higher coverage with lower valency, but are less feasible. In principle, very high coverage could be achieved with lower valency O-based vaccines, however, the protective efficacy against disease of antibodies targeting the O antigen remains uncertain. Further research is needed on cross-reactivity, antigen exposure, and stability of antigens over time, to better inform vaccine development.
Authors
- Allan Zuza (ORCID: https://orcid.org/0000-0002-2772-5779)
- S. Amin (ORCID: https://orcid.org/0000-0002-8304-6519)
- Jonathan Strysko (ORCID: https://orcid.org/0000-0002-5258-7654)
- Thomas D. Stanton
- Oliver Pearse (ORCID: https://orcid.org/0009-0000-6285-0893)
- Alexander M. Aiken (ORCID: https://orcid.org/0000-0003-3372-9036)
- David Ojok (ORCID: https://orcid.org/0009-0007-0837-4460)
- Steven M. Jones (ORCID: https://orcid.org/0000-0002-1055-3675)
- Paul J. Planet (ORCID: https://orcid.org/0000-0003-0543-0539)
- Caroline Tigoi (ORCID: https://orcid.org/0000-0003-2750-7533)
- Aniqa Abdul Rasool (ORCID: https://orcid.org/0000-0002-8645-9669)
- Joveria Farooqi (ORCID: https://orcid.org/0000-0002-9921-4660)
- Kelly L. Wyres (ORCID: https://orcid.org/0000-0002-4033-6639)
- Boaz Wadugu (ORCID: https://orcid.org/0009-0000-8632-859X)
- Chileshe Lukwesa Musyani
- Eva Heinz
- John Tembo
- Wilson Gumbi (ORCID: https://orcid.org/0000-0003-1895-3187)
- Samiah Kanwar (ORCID: https://orcid.org/0000-0003-1719-6807)
- Ahmed M. Moustafa (ORCID: https://orcid.org/0000-0002-9949-6936)
- Kyle Bittinger (ORCID: https://orcid.org/0000-0003-3472-5934)
- Laura Phillips (ORCID: https://orcid.org/0000-0002-6453-0129)
- Rindidzani E. Magobo (ORCID: https://orcid.org/0000-0002-0950-0146)
- Carolyn McGann (ORCID: https://orcid.org/0000-0002-4066-0893)
- Donwilliams O. Omuoyo (ORCID: https://orcid.org/0000-0003-3900-5354)
- Davidson H. Hamer (ORCID: https://orcid.org/0000-0002-4700-1495)
- Kirsty Sands (ORCID: https://orcid.org/0000-0001-5049-4481)
- Varsha Mittal
- Ruchi Nanavati
- J. W. Cornick
- K. K. Jain
- Erin Theiller
- Shaun P Keegan
- Moreka L Ndumba
- Atul Jindal
- Timothy R. Walsh
- Apurba Sastry
- Noah Obeng-Nkrumah
- Samir K. Saha
- Adhisivam Bethou
- James C.L. Mwansa
- Weiming Hu
- Angela Dramowski
- Sombo Fwoloshi
- Senjuti Saha
- M. Jeeva Sankar
- Appiah-Korang Labi
- Sulagna Basu
- Courtney P. Olwagen
- Furqan Kabir
- Muhammad Imran Nisar
- Nicholas A. Feasey
- Nelesh P. Govender
- Najia Ghanchi
- Kathryn E. Holt
- Naveed Iqbal (ORCID: https://orcid.org/0000-0001-8631-9191)
- Yogesh Hooda
- Semaria Solomon Alemayehu
- Susan E. Coffin
- Erkison E. Odih
- Andrew C. Whitelaw
- Erum Khan
- Rabaab Zahra
- Anudita Bhargava
- Anne V. Amulele
- James A. Berkley
- Patrick Musicha
- Arif M. Tanmoy
- Jean-Baptiste Mazarati
- Shabir A. Madhi
- Priyanka S. Prasad
- Tolbert Sonda
- Matthew T Bates
- Waqasuddin Khan
- Lola Madrid
- Aneeta Hotwani
- Fyezah Jehan
- Charlene M. C. Rodrigues (ORCID: https://orcid.org/0000-0003-0942-3707)
- Grace J. Chan
- Jabir A. Abdulahi
- Ramesh K. Agarwal
Institutions
- Human Sciences Research Council (ZA)
- National Health Laboratory Service (ZA)
- South African Medical Research Council (ZA)
- Boston University (US)
- Aga Khan University (PK)
- Quaid-i-Azam University (PK)
- Centre for Infectious Disease Research in Zambia (ZM)
- All India Institute of Medical Sciences Raipur (IN)
- National Security Agency (US)
- Western Cape Department of Health (ZA)
- Children's Hospital of Philadelphia (US)
- Ministry of Health (ZM)
- University of Ghana (GH)
- Balochistan University of Information Technology, Engineering and Management Sciences (PK)
- University of Liverpool (GB)
- Imperial College Healthcare NHS Trust (GB)
- Haramaya University (ET)
- University of Botswana (BW)
- University of St Andrews (GB)
- University of Strathclyde (GB)
- University of the Witwatersrand (ZA)
- King Edward Memorial Hospital and Seth G.S. Medical College (IN)
- Liverpool School of Tropical Medicine (GB)
- Trinity College Dublin (IE)
- University of Health and Allied Sciences (GH)
- Stellenbosch University (ZA)
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme (MW)
- Wellcome Sanger Institute (GB)
- University Teaching Hospital (ZM)
- Tygerberg Hospital (ZA)
- Kenya Medical Research Institute (KE)
- Lusaka Apex Medical University (ZM)
- University of Zambia (ZM)
- University of Oxford (GB)
- London School of Hygiene & Tropical Medicine (GB)
- National Hospital Abuja (NG)
- Golden Valley Agricultural Research Trust (ZM)
- INES-Ruhengeri (RW)
- Kilimanjaro Christian Medical Centre (TZ)
- National Institute of Research in Tuberculosis (IN)
- Pamoja Tunaweza Women's Centre (TZ)
- Child Health Research Foundation (BD)
- Center for Genomic Science (IT)
- St. James's Hospital (IE)
- St. Paul's Hospital Millennium Medical College (ET)
- National Institute of Public Administration (ZM)
- National Institute for Communicable Diseases
- Kamuzu University of Health Sciences (MW)
- University of Lincoln (GB)
- Monash University (AU)
- Jawaharlal Institute of Post Graduate Medical Education and Research (IN)
- All India Institute of Medical Sciences (IN)
- Cardiff University (GB)
- University of Pennsylvania (US)
- University of Abuja (NG)
Publication Details
- Journal
- PLoS Medicine
- Published
- 2026-01-12
- DOI
- https://doi.org/10.1371/journal.pmed.1004879
- Citations
- 1
- Primary Topic
- Neonatal and Maternal Infections
- Type
- article
- Field-Weighted Citation Impact
- 41.85