<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1683-9803</journal-id>
<journal-title><![CDATA[Pediatría (Asunción)]]></journal-title>
<abbrev-journal-title><![CDATA[Pediatr. (Asunción)]]></abbrev-journal-title>
<issn>1683-9803</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Pediatría]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1683-98032025000100013</article-id>
<article-id pub-id-type="doi">10.31698/ped.52012025004</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Neumonía adquirida en la comunidad e inmunización a Streptococcus pneumoniae en menores de 59 meses. Periodos pre y pandémico]]></article-title>
<article-title xml:lang="en"><![CDATA[Community-acquired pneumonia and immunization to Streptococcus pneumonie in children under 59 months. Pre- and pandemic periods]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González Yanet]]></surname>
<given-names><![CDATA[Camila]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Grau]]></surname>
<given-names><![CDATA[Lorena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mesquita Ramírez]]></surname>
<given-names><![CDATA[Mirta N.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General Pediátrico &#8220;Niños de Acosta Ñu&#8221;  ]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Católica Nuestra Señora de la Asunción  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital General Pediátrico &#8220;Niños de Acosta Ñu&#8221; Departamento de Epidemiología ]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital General Pediátrico &#8220;Niños de Acosta Ñu&#8221; Departamento de Docencia e Investigación ]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2025</year>
</pub-date>
<volume>52</volume>
<numero>1</numero>
<fpage>13</fpage>
<lpage>23</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1683-98032025000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1683-98032025000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1683-98032025000100013&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: La neumonía es una de las principales causas de muerte en menores de 5 años.  Objetivos:  describir las características demográficas, microbiológicas y estado de inmunización contra el Streptococcus pneumoniae, (S.pneumoniae) de pacientes menores de 59 meses, hospitalizados, con los diagnósticos de neumonía adquirida en la comunidad (NAC) probable o confirmada, en el periodo comprendido entre enero del 2017 a agosto del 2022.  Materiales y Métodos:  estudio observacional descriptivo, transversal retrospectivo. A partir de la base de VINUVA, fueron incluidos pacientes menores de 5 años con diagnóstico de NAC probable o confirmada. Variables edad, genero, tipo de NAC, retorno bacteriológico (cultivos y estudio molecular), serotipificación, inmunización con PCV y evolución. Los datos fueron analizados con SPSS. El comité de ética aprobó el protocolo de estudio.  Resultados: Fueron incluidos 593 pacientes, con una mediana edad 22 meses, 52,8% masculino, 72,8% tenían NAC probable y 27,2% NAC confirmada. Tenían vacuna PCV 64,9%. S. pneumoniae se aisló en el 84%, de las NAC confirmadas con predominio de serotipos vacunales. El 9,8% fueron neumonías severas e ingresaron a la unidad de terapia intensiva pediátrica. Durante la pandemia las hospitalizaciones y la inmunización con PCV disminuyeron, acompañado de aumento de las neumonías por S. pneumoniae. La mortalidad total fue 3,4%.  Conclusiones. Hubo predominio de menores de 24 meses, de género masculino. El Streptococcus pneumoniae de serotipo vacunal predominó en los aislamientos. Formas graves de neumonía se observó en el 9,8% y la mortalidad global fue 3,4%. Durante la pandemia disminuyo cobertura vacunal con PCV y aumento la NAC causada por el S.pneumoniae.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction: Pneumonia is one of the leading causes of death in children under 5 years of age. Objectives: To describe the demographic and microbiological characteristics and immunization status against Streptococcus pneumoniae (S. pneumoniae) of hospitalized patients under 59 months of age with diagnoses of probable or confirmed community-acquired pneumonia (CAP) from January 2017 to August 2022.  Materials and Methods:  This was a retrospective, cross-sectional and descriptive observational study. Based on the VINUVA database, patients under 5 years of age with a diagnosis of probable or confirmed CAP were included. Variables included age, gender, CAP type, bacteriological results (cultures and molecular testing), serotyping, PCV immunization, and outcome. Data were analyzed using SPSS. The study protocol was approved by the institutional ethics committee.  Results:  A total of 593 patients were included, with a median age of 22 months; 52.8% were male; 72.8% had probable CAP; and 27.2% had confirmed CAP. A total of 64.9% had received PCV vaccination. S. pneumoniae was isolated in 84% of confirmed CAP, with a predominance of vaccine serotypes. 9.8% were severe pneumonias and were admitted to the pediatric intensive care unit. During the pandemic, hospitalizations and PCV immunization decreased, accompanied by an increase in S. pneumoniae pneumonia. The overall mortality rate was 3.4%.  Conclusions: There was a predominance of children under 24 months of age and males in our study population. The vaccine-derived Streptococcus pneumoniae serotype predominated in the isolates. Severe pneumonia was observed in 9.8% of cases, and overall mortality was 3.4%. During the pandemic, PCV vaccination coverage decreased, and CAP caused by S. pneumoniae increased.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Neumonía]]></kwd>
<kwd lng="es"><![CDATA[Streptococcus pneumoniae]]></kwd>
<kwd lng="es"><![CDATA[vacuna]]></kwd>
<kwd lng="es"><![CDATA[niños]]></kwd>
<kwd lng="en"><![CDATA[Pneumonia]]></kwd>
<kwd lng="en"><![CDATA[Streptococcus pneumoniae]]></kwd>
<kwd lng="en"><![CDATA[vaccine]]></kwd>
<kwd lng="en"><![CDATA[children]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[Children improving survival and well-being]]></source>
<year>2024</year>
<publisher-name><![CDATA[WHO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rees]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Kuppermann]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Florin]]></surname>
<given-names><![CDATA[TA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Community-Acquired Pneumonia in Children]]></article-title>
<source><![CDATA[Pediatr Emerg Care]]></source>
<year>2023</year>
<volume>39</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>968-76</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kovács]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Sahin-Tóth]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Tóthpál]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[van der Linden]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Tirczka]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Dobay]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Co-carriage of Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis among three different age categories of children in Hungary]]></article-title>
<source><![CDATA[PLoS One]]></source>
<year>2020</year>
<volume>15</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="">
<collab>GBD 2021 Lower Respiratory Infections and Antimicrobial Resistance Collaborators</collab>
<article-title xml:lang=""><![CDATA[Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021]]></article-title>
<source><![CDATA[Lancet Infect Dis]]></source>
<year>2024</year>
<volume>24</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>974-1002</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Reyburn]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Maher]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[von Mollendorf]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Gwee]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mulholland]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Russell]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The impact of the introduction of ten- or thirteen-valent pneumococcal conjugate vaccines on antimicrobial-resistant pneumococcal disease and carriage: A systematic literature review]]></article-title>
<source><![CDATA[Glob Health]]></source>
<year>2023</year>
<volume>13</volume>
<page-range>05001</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barbieri]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Porcu]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Hu]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Petigara]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Senese]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Prandi]]></surname>
<given-names><![CDATA[GM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Retrospective Analysis to Estimate the Burden of Invasive Pneumococcal Disease and Non-Invasive Pneumonia in Children &lt;15 Years of Age in the Veneto Region, Italy]]></article-title>
<source><![CDATA[Children]]></source>
<year>2022</year>
<volume>9</volume>
<page-range>657</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Masomian]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ahmad]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Gew]]></surname>
<given-names><![CDATA[LT]]></given-names>
</name>
<name>
<surname><![CDATA[Poh]]></surname>
<given-names><![CDATA[CL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Development of Next Generation Streptococcus pneumoniae Vaccines Conferring Broad Protection]]></article-title>
<source><![CDATA[Vaccines]]></source>
<year>2020</year>
<numero>8</numero>
<issue>8</issue>
<page-range>132</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stacey]]></surname>
<given-names><![CDATA[HL]]></given-names>
</name>
<name>
<surname><![CDATA[Rosen]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Peterson]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Williams-Diaz]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Gakhar]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Sterling]]></surname>
<given-names><![CDATA[TM]]></given-names>
</name>
</person-group>
<source><![CDATA[Safety and immunogenicity of 15-valent pneumococcal conjugate vaccine (PCV-15) compared to PCV-13 in healthy older adults. Hum Vaccin Immunother]]></source>
<year>2019</year>
<volume>15</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>530-9</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Micoli]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Romano]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Carboni]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Adamo]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Berti]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Strengths and weaknesses of pneumococcal conjugate vaccines]]></article-title>
<source><![CDATA[Glycoconj J]]></source>
<year>2023</year>
<numero>40</numero>
<issue>40</issue>
<page-range>135-48</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lewnard]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Givon-Lavi]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Dagan]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effectiveness of Pneumococcal Conjugate Vaccines Against Community-acquired Alveolar Pneumonia Attributable to Vaccine-serotype Streptococcus pneumoniae Among Children]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2021</year>
<volume>73</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>e1423-33</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Feemster]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Buchwald]]></surname>
<given-names><![CDATA[UK]]></given-names>
</name>
<name>
<surname><![CDATA[Banniettis]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Joyce]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
<name>
<surname><![CDATA[Velentgas]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Chapman]]></surname>
<given-names><![CDATA[TJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Immunogenicity of Current and Next-Generation Pneumococcal Conjugate Vaccines in Children : Current Challenges and Upcoming Opportunities]]></article-title>
<source><![CDATA[Open Forum Infect Dis]]></source>
<year>2024</year>
<volume>11</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>ofae220</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Agudelo]]></surname>
<given-names><![CDATA[CI]]></given-names>
</name>
<name>
<surname><![CDATA[Castañeda-Orjuela]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Brandileone MC de]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Echániz-Aviles]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[SCG]]></given-names>
</name>
<name>
<surname><![CDATA[Carnalla-Barajas]]></surname>
<given-names><![CDATA[MN]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The direct effect of pneumococcal conjugate vaccines on invasive pneumococcal disease in children in the Latin American and Caribbean region (SIREVA 2006-17): a multicenter, retrospective observational study]]></article-title>
<source><![CDATA[Lancet Infect Dis]]></source>
<year>2021</year>
<volume>21</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>405-17</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="book">
<collab>Ministerio de Salud Pública y Bienestar Social</collab>
<source><![CDATA[Programa ampliado de inmunizaciones]]></source>
<year>2022</year>
<publisher-name><![CDATA[MSPyBS]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gentilotti]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[De Nardo]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Cremonini]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Górska]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mazzaferri]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Canziani]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnostic accuracy of point-of-care tests in acute community-acquired lower respiratory tract infections. A systematic review and meta-analysis]]></article-title>
<source><![CDATA[Clin Microbiol Infect]]></source>
<year>2022</year>
<volume>28</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>13-22</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guan]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Gao]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Zhao]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Zhou]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Yu]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical characteristics of hospitalized term and preterm infants with community&#8209;acquired viral pneumonia]]></article-title>
<source><![CDATA[BMC Pediatrics]]></source>
<year>2022</year>
<numero>22</numero>
<issue>22</issue>
<page-range>452</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ma]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Yuan]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Luo]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiological characteristics of severe community-acquired pneumonia in children admitted to two tertiary hospitals in Shihezi, Xinjiang Region, China in 2023: a cross-sectional analysis]]></article-title>
<source><![CDATA[J Thorac Dis]]></source>
<year>2024</year>
<volume>16</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>6969-82</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mao]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coinfection of viruses in children with community&#8209;acquired pneumonia]]></article-title>
<source><![CDATA[BMC Pediatrics]]></source>
<year>2024</year>
<numero>24</numero>
<issue>24</issue>
<page-range>457</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lokida]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Farida]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Triasih]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Mardian]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Kosasih]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Naysilla]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology of community-acquired pneumonia among hospitalized children in Indonesia: a multicenter, prospective study]]></article-title>
<source><![CDATA[BMJ Open]]></source>
<year>2022</year>
<numero>12</numero>
<issue>12</issue>
</nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rueda]]></surname>
<given-names><![CDATA[ZV]]></given-names>
</name>
<name>
<surname><![CDATA[Aguilar]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Maya]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Lopez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Restrepo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Garces]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Etiology and the challenge of diagnostic testing of community-acquired pneumonia in children and adolescents]]></article-title>
<source><![CDATA[BMC Pediatrics]]></source>
<year>2022</year>
<numero>22</numero>
<issue>22</issue>
<page-range>169</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bénet]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez Picot]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Messaoudi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Chou]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Eap]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Microorganisms Associated with Pneumonia in Children &lt;5 Years of Age in Developing and Emerging Countries: The GABRIEL Pneumonia Multicenter, Prospective, Case-Control Study]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2017</year>
<volume>65</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>604-12</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pimenta]]></surname>
<given-names><![CDATA[FC]]></given-names>
</name>
<name>
<surname><![CDATA[Moiane]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Lessa]]></surname>
<given-names><![CDATA[FC]]></given-names>
</name>
<name>
<surname><![CDATA[Venero]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
<name>
<surname><![CDATA[Moura]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Larson]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Dried blood spots for Streptococcus pneumoniae and Haemophilus influenzae detection and serotyping among children &lt; 5 years old in rural Mozambique]]></article-title>
<source><![CDATA[BMC Pediatr]]></source>
<year>2020</year>
<volume>20</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>326</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Meyer Sauteur]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Childhood community&#8209;acquired pneumonia]]></article-title>
<source><![CDATA[Eur J Pediatr]]></source>
<year>2024</year>
<numero>183</numero>
<issue>183</issue>
<page-range>1129-36</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Combs]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Liberman]]></surname>
<given-names><![CDATA[DB]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Decreasing Blood Culture Collection in Hospitalized Patients with CAP, SSTI, and UTI]]></article-title>
<source><![CDATA[Pediatr Qual Saf]]></source>
<year>2023</year>
<numero>8</numero>
<issue>8</issue>
</nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vidal]]></surname>
<given-names><![CDATA[AGJ]]></given-names>
</name>
<name>
<surname><![CDATA[Francis]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Chitanvis]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Takeshita]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Frame]]></surname>
<given-names><![CDATA[IJ]]></given-names>
</name>
<name>
<surname><![CDATA[Sharma]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fluorescent antibody-based detection and ultrastructural analysis of Streptococcus pneumoniae in human sputum]]></article-title>
<source><![CDATA[Pneumonia (Nathan)]]></source>
<year>2025</year>
<volume>17</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>4</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yun]]></surname>
<given-names><![CDATA[KW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment]]></article-title>
<source><![CDATA[Clin Exp Pediatr]]></source>
<year>2024</year>
<volume>67</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>80-9</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Johnson]]></surname>
<given-names><![CDATA[CN]]></given-names>
</name>
<name>
<surname><![CDATA[Wilde]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Tuomanen]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Rosch]]></surname>
<given-names><![CDATA[JW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Convergent impact of vaccination and antibiotic pressures on pneumococcal populations.]]></article-title>
<source><![CDATA[Cell Chem Biol]]></source>
<year>2024</year>
<volume>31</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>195-206</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Filtenborg Tvedskov]]></surname>
<given-names><![CDATA[ES]]></given-names>
</name>
<name>
<surname><![CDATA[Hovmand]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Benfield]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Tinggaard]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pneumococcal carriage among children in low and lower-middle-income countries: A systematic review]]></article-title>
<source><![CDATA[Int J Infect Dis]]></source>
<year>2022</year>
<numero>115</numero>
<issue>115</issue>
<page-range>1-7</page-range></nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Ang]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Akksilp]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Koh]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Scott]]></surname>
<given-names><![CDATA[AG]]></given-names>
</name>
<name>
<surname><![CDATA[Mark KJit]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Re-evaluating the impact and cost-effectiveness of pneumococcal conjugate vaccine introduction in 112 low-income and middle-income countries in children younger than 5 years: a modelling study]]></article-title>
<source><![CDATA[Lancet Glob Health]]></source>
<year>2024</year>
<numero>12</numero>
<issue>12</issue>
<page-range>e1485-97</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ulanova]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Health inequalities in respiratory tract infections - beyond COVID-19]]></article-title>
<source><![CDATA[Curr Opin Infect Dis]]></source>
<year>2025</year>
<volume>38</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>161-8</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ciruela]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Soldevila]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[García-Garcia]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[González-Peris]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz-Conradi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Redin]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effect of COVID-19 Pandemic on Invasive Pneumococcal Disease inChildren , Catalonia, Spain]]></article-title>
<source><![CDATA[Emerg Infect Dis]]></source>
<year>2022</year>
<volume>28</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>2321-5</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brueggemann]]></surname>
<given-names><![CDATA[AB]]></given-names>
</name>
<name>
<surname><![CDATA[Jansen Van Rensburg]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Shaw]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Mccarthy]]></surname>
<given-names><![CDATA[ND]]></given-names>
</name>
<name>
<surname><![CDATA[Jolley]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
<name>
<surname><![CDATA[Maiden]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Changes in the incidence of invasive disease due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the Invasive Respiratory Infection Surveillance Initiative: a prospective analysis of surveillance data.]]></article-title>
<source><![CDATA[Lancet Digit Health]]></source>
<year>2021</year>
<numero>3</numero>
<issue>3</issue>
<page-range>e360-70</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Danino]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Ben-Shimol]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[van der Beek]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Givon-Lavi]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Avni]]></surname>
<given-names><![CDATA[YS]]></given-names>
</name>
<name>
<surname><![CDATA[Greenberg]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Decline in Pneumococcal Disease in Young Children During the Coronavirus Disease 2019 (COVID-19) Pandemic in Israel Associated With Suppression of Seasonal Respiratory Viruses, Despite Persistent Pneumococcal Carriage: A Prospective Cohort Study]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2022</year>
<volume>75</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>e1154-64</page-range></nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zhao]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Pan]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Sun]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology characteristics of Streptococcus pneumoniae from children with pneumonia in Shanghai: A retrospective study]]></article-title>
<source><![CDATA[Front Cell Infect Microbiol]]></source>
<year>2019</year>
<numero>9</numero>
<issue>9</issue>
</nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ahmed]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Lessa]]></surname>
<given-names><![CDATA[FC]]></given-names>
</name>
<name>
<surname><![CDATA[Coradin]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Carvalho]]></surname>
<given-names><![CDATA[MDG]]></given-names>
</name>
<name>
<surname><![CDATA[Soda]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[High Prevalence of Vaccine-Type Infections among Children with Pneumococcal Pneumonia and Effusion after 13-Valent Pneumococcal Conjugate Vaccine Introduction in the Dominican Republic]]></article-title>
<source><![CDATA[J Infect Dis]]></source>
<year>2021</year>
<numero>224</numero>
<issue>224</issue>
<page-range>S228-36</page-range></nlm-citation>
</ref>
<ref id="B35">
<label>35</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Camacho-Moreno G]]></surname>
<given-names><![CDATA[Duarte C]]></given-names>
</name>
<name>
<surname><![CDATA[García D]]></surname>
<given-names><![CDATA[Calderón V]]></given-names>
</name>
<name>
<surname><![CDATA[Maldonado LY]]></surname>
<given-names><![CDATA[Castellar]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sentinel surveillance for bacterial pneumonia and meningitis in children under the age of 5 in a tertiary pediatric hospital in Colombia 2016]]></article-title>
<source><![CDATA[Biomédica]]></source>
<year>2021</year>
<volume>41</volume>
<numero>^sSupl.2</numero>
<issue>^sSupl.2</issue>
<supplement>Supl.2</supplement>
<page-range>62-75</page-range></nlm-citation>
</ref>
<ref id="B36">
<label>36</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Agudelo]]></surname>
<given-names><![CDATA[CI]]></given-names>
</name>
<name>
<surname><![CDATA[DeAntonio]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Castañeda]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Streptococcus pneumoniae serotype 19A in Latin America and the Caribbean 2010-2015: A systematic review and a time series analysis]]></article-title>
<source><![CDATA[Vaccine]]></source>
<year>2018</year>
<volume>36</volume>
<numero>32</numero>
<issue>32</issue>
<page-range>4861-74</page-range></nlm-citation>
</ref>
<ref id="B37">
<label>37</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Awasthi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Pandey]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
<name>
<surname><![CDATA[Mishra]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[CAP Study]]></surname>
<given-names><![CDATA[Gr]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Identifying risk of death in children hospitalized with community-acquired pneumonia]]></article-title>
<source><![CDATA[Bull World Health Organ]]></source>
<year>2023</year>
<volume>101</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>281-9</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
