Trends in Streptococcus pneumoniae serotypes and antimicrobial resistance in Italy (2007–2023): A mixed-effects model analysis of invasive pneumococcal disease

Our findings highlight the evolving pneumococcal landscape in the post-PCV13 era, with emerging serotypes contributing significantly to IPD burden. The observed serotype-specific AMR patterns underscore the importance of integrated surveillance to support regionally tailored immunisation strategies and empirical therapy choices. Expanded-valency vaccines may offer broader protection against emerging serotypes.