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"https://www.academia.edu/login?post_login_redirect_url=https%3A%2F%2Fwww.academia.edu%2F60799137%2FGlobal_serotype_distribution_among_Streptococcus_pneumoniae_isolates_causing_otitis_media_in_children_Potential_implications_for_pneumococcal_conjugate_vaccines%3Fshow_translation%3Dtrue"; window.loswp.previewableAttachments = [{"id":74083199,"identifier":"Attachment_74083199","shouldShowBulkDownload":false}]; window.loswp.shouldDetectTimezone = true; window.loswp.shouldShowBulkDownload = true; window.loswp.showSignupCaptcha = false window.loswp.willEdgeCache = false; window.loswp.work = {"work":{"id":60799137,"created_at":"2021-11-02T05:51:17.215-07:00","from_world_paper_id":182717874,"updated_at":"2025-01-31T21:54:45.903-08:00","_data":{"publisher":"Elsevier BV","ai_title_tag":"Pneumococcal Serotypes in Pediatric Otitis Media","grobid_abstract":"Acute otitis media (AOM) is the most common infection following pneumococcal colonization of the upper respiratory tract. Streptococcus pneumoniae causes 30-60% of AOM cases worldwide. However, not all pneumococcal serotypes cause disease and an association exists with nasopharyngeal colonization by certain serotypes and their propensity to cause AOM. This review examines the global serotype distribution relationship between pneumococcal serotypes and AOM in children aged \u003c18 years and demonstrates that the most common pneumococcal serotypes causing AOM globally are 3, 6A, 6B, 9V, 14, 19A, 19F, and 23F.","publication_date":"2009,,","publication_name":"Vaccine","grobid_abstract_attachment_id":"74083199"},"document_type":"paper","pre_hit_view_count_baseline":null,"quality":"high","language":"en","title":"Global serotype distribution among Streptococcus pneumoniae isolates causing otitis media in children: Potential implications for pneumococcal conjugate vaccines","broadcastable":false,"draft":null,"has_indexable_attachment":true,"indexable":true}}["work"]; window.loswp.workCoauthors = [55927497]; window.loswp.locale = "en"; window.loswp.countryCode = "SG"; window.loswp.cwvAbTestBucket = ""; window.loswp.designVariant = "ds_vanilla"; window.loswp.fullPageMobileSutdModalVariant = "control"; window.loswp.useOptimizedScribd4genScript = false; window.loginModal = {}; window.loginModal.appleClientId = 'edu.academia.applesignon'; window.userInChina = "false";</script><script defer="" src="https://accounts.google.com/gsi/client"></script><div class="ds-loswp-container"><div class="ds-work-card--grid-container"><div class="ds-work-card--container js-loswp-work-card"><div class="ds-work-card--cover"><div class="ds-work-cover--wrapper"><div class="ds-work-cover--container"><button class="ds-work-cover--clickable js-swp-download-button" data-signup-modal="{"location":"swp-splash-paper-cover","attachmentId":74083199,"attachmentType":"pdf"}"><img alt="First page of “Global serotype distribution among Streptococcus pneumoniae isolates causing otitis media in children: Potential implications for pneumococcal conjugate vaccines”" class="ds-work-cover--cover-thumbnail" src="https://0.academia-photos.com/attachment_thumbnails/74083199/mini_magick20211102-22414-lyu4qx.png?1635857574" /><img alt="PDF Icon" class="ds-work-cover--file-icon" src="//a.academia-assets.com/images/single_work_splash/adobe_icon.svg" /><div class="ds-work-cover--hover-container"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span><p>Download Free PDF</p></div><div class="ds-work-cover--ribbon-container">Download Free PDF</div><div class="ds-work-cover--ribbon-triangle"></div></button></div></div></div><div class="ds-work-card--work-information"><h1 class="ds-work-card--work-title">Global serotype distribution among Streptococcus pneumoniae isolates causing otitis media in children: Potential implications for pneumococcal conjugate vaccines</h1><div class="ds-work-card--work-authors ds-work-card--detail"><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="55927497" href="https://independent.academia.edu/AdrianoArguedas"><img alt="Profile image of Adriano Arguedas" class="ds-work-card--author-avatar" src="//a.academia-assets.com/images/s65_no_pic.png" />Adriano Arguedas</a></div><div class="ds-work-card--detail"><p class="ds-work-card--detail ds2-5-body-sm">2009, Vaccine</p><div class="ds-work-card--work-metadata"><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">visibility</span><p class="ds2-5-body-sm" id="work-metadata-view-count">…</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">description</span><p class="ds2-5-body-sm">9 pages</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">link</span><p class="ds2-5-body-sm">1 file</p></div></div><script>(async () => { const workId = 60799137; const worksViewsPath = "/v0/works/views?subdomain_param=api&work_ids%5B%5D=60799137"; const getWorkViews = async (workId) => { const response = await fetch(worksViewsPath); if (!response.ok) { throw new Error('Failed to load work views'); } const data = await response.json(); return data.views[workId]; }; // Get the view count for the work - we send this immediately rather than waiting for // the DOM to load, so it can be available as soon as possible (but without holding up // the backend or other resource requests, because it's a bit expensive and not critical). const viewCount = await getWorkViews(workId); const updateViewCount = (viewCount) => { try { const viewCountNumber = parseInt(viewCount, 10); if (viewCountNumber === 0) { // Remove the whole views element if there are zero views. document.getElementById('work-metadata-view-count')?.parentNode?.remove(); return; } const commaizedViewCount = viewCountNumber.toLocaleString(); const viewCountBody = document.getElementById('work-metadata-view-count'); if (!viewCountBody) { throw new Error('Failed to find work views element'); } viewCountBody.textContent = `${commaizedViewCount} views`; } catch (error) { // Remove the whole views element if there was some issue parsing. document.getElementById('work-metadata-view-count')?.parentNode?.remove(); throw new Error(`Failed to parse view count: ${viewCount}`, error); } }; // If the DOM is still loading, wait for it to be ready before updating the view count. if (document.readyState === "loading") { document.addEventListener('DOMContentLoaded', () => { updateViewCount(viewCount); }); // Otherwise, just update it immediately. } else { updateViewCount(viewCount); } })();</script></div><p class="ds-work-card--work-abstract ds-work-card--detail ds2-5-body-md">Acute otitis media (AOM) is the most common infection following pneumococcal colonization of the upper respiratory tract. Streptococcus pneumoniae causes 30-60% of AOM cases worldwide. However, not all pneumococcal serotypes cause disease and an association exists with nasopharyngeal colonization by certain serotypes and their propensity to cause AOM. This review examines the global serotype distribution relationship between pneumococcal serotypes and AOM in children aged <18 years and demonstrates that the most common pneumococcal serotypes causing AOM globally are 3, 6A, 6B, 9V, 14, 19A, 19F, and 23F.</p><div class="ds-work-card--button-container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--work-card","attachmentId":74083199,"attachmentType":"pdf","workUrl":"https://www.academia.edu/60799137/Global_serotype_distribution_among_Streptococcus_pneumoniae_isolates_causing_otitis_media_in_children_Potential_implications_for_pneumococcal_conjugate_vaccines"}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--work-card","attachmentId":74083199,"attachmentType":"pdf","workUrl":"https://www.academia.edu/60799137/Global_serotype_distribution_among_Streptococcus_pneumoniae_isolates_causing_otitis_media_in_children_Potential_implications_for_pneumococcal_conjugate_vaccines"}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div><div class="ds-signup-banner-trigger-container"><div class="ds-signup-banner-trigger ds-signup-banner-trigger-control"></div></div><div class="ds-signup-banner ds-signup-banner-control"><div id="ds-signup-banner-close-button"><button class="ds2-5-button ds2-5-button--secondary ds2-5-button--inverse"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">close</span></button></div><div class="ds-signup-banner-ctas"><img src="//a.academia-assets.com/images/academia-logo-capital-white.svg" /><h4 class="ds2-5-heading-serif-sm">Sign up for access to the world's latest research</h4><button class="ds2-5-button ds2-5-button--inverse ds2-5-button--full-width js-swp-download-button" data-signup-modal="{"location":"signup-banner"}">Sign up for free<span class="material-symbols-outlined" style="font-size: 20px" translate="no">arrow_forward</span></button></div><div class="ds-signup-banner-divider"></div><div class="ds-signup-banner-reasons"><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Get notified about relevant papers</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Save papers to use in your research</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Join the discussion with peers</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Track your impact</span></div></div></div><script>(() => { // Set up signup banner show/hide behavior: // 1. 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Pneumococcal conjugate vaccine (PCV) programs have altered pneumococcal serotype epidemiology in disease and carriage. To establish the clinical picture of AOM in young children exposed to the PCV program in Belgium and the Sp strains they carry, a cross-sectional study started in 2016.Material/methodsIn three collection periods from February 2016 to May 2018, nasopharyngeal swabs and background characteristics were collected from children aged 6-30 months either presenting at their physician with AOM (AOM-group) or healthy and attending day care (DCC-group). Sp was detected, quantified, and characterized using both conventional culture and qPCR. Clinical signs of AOM episodes and treatment were registered by the physicians.ResultsAmong 3264 collected samples, overall pneumococcal carriage and density were similar in AOM (79.2% and 0.50 ×106 copies/μl) and DCC (77.5% and 0.42 ×106 copies/μl). Non-v...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Streptococcus pneumoniae serotypes carried by young children and their association with Acute Otitis Media during the period 2016 – 2019","attachmentId":85611841,"attachmentType":"pdf","work_url":"https://www.academia.edu/78628895/Streptococcus_pneumoniae_serotypes_carried_by_young_children_and_their_association_with_Acute_Otitis_Media_during_the_period_2016_2019","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/78628895/Streptococcus_pneumoniae_serotypes_carried_by_young_children_and_their_association_with_Acute_Otitis_Media_during_the_period_2016_2019"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="1" data-entity-id="90824600" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/90824600/Multinational_study_of_pneumococcal_serotypes_causing_acute_otitis_media_in_children">Multinational study of pneumococcal serotypes causing acute otitis media in children</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="10705651" href="https://independent.academia.edu/brianwynne">brian wynne</a></div><p class="ds-related-work--metadata ds2-5-body-xs">The Pediatric Infectious Disease Journal, 2002</p><p class="ds-related-work--abstract ds2-5-body-sm">Background. Streptococcus pneumoniae is a major cause of acute otitis media (AOM) in young children. More than 90 immunologically distinct pneumococcal serotypes have been identified, but limited information is available regarding their relative importance in AOM. Methods. We analyzed nine existing datasets comprising pneumococcal isolates from middle ear fluid samples collected from 1994 through 2000 from 3232 children with AOM from Finland, France, Greece, Israel, several East European countries, the US and Argentina. We examined the distribution of pneumococcal serotypes in relation to several demographic and epidemiologic variables, including gender, age, antibiotic resistance and source of culture material. Results. The major serotypes identified included 19F and 23F, each comprising 13 to 25% of pneumococcal middle ear fluid isolates in most datasets; 14 and 6B, comprising 6 to 18%; whereas 6A, 19A and 9V each comprised 5 to 10%. Despite differences in location, study design and antibiotic susceptibility, each major serotype was prominent in most age groups of each dataset. Serotypes represented in the 7-valent pneumococcal conjugate vaccine (PCV-7, 4, 6B, 9V, 14, 18C, 19F, 23F) accounted for 60 to 70% of all pneumococcal isolates in the 6-to 59-month age range, but only 40 to 50% of isolates in children <6 or >60 months old. Serotype 3 and, in certain datasets, serotypes 1 and 5, were more important in the <6and >60-month age groups. In each age group vaccine-related serotypes (mainly 6A and 19A) comprised an additional 10 to 15% of all pneumococcal isolates. Four serotypes (23F, 19F, 14 and 6B) accounted for 83% of all penicillinresistant observations. Conclusions. This analysis of several geographically diverse datasets indicates that a limited number of serotypes, largely represented in PCV-7, accounted for the majority of episodes of pneumococcal AOM in children between 6 and 59 months of age. Certain serotypes appeared to be relatively more significant in children <6 months or >59 months of age.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Multinational study of pneumococcal serotypes causing acute otitis media in children","attachmentId":94280662,"attachmentType":"pdf","work_url":"https://www.academia.edu/90824600/Multinational_study_of_pneumococcal_serotypes_causing_acute_otitis_media_in_children","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/90824600/Multinational_study_of_pneumococcal_serotypes_causing_acute_otitis_media_in_children"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="2" data-entity-id="14759612" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/14759612/Dynamics_of_Streptococcus_pneumoniae_Serotypes_Causing_Acute_Otitis_Media_Isolated_from_Children_with_Spontaneous_Middle_Ear_Drainage_over_a_12_Year_Period_1999_2010_in_a_Region_of_Northern_Spain">Dynamics of Streptococcus pneumoniae Serotypes Causing Acute Otitis Media Isolated from Children with Spontaneous Middle-Ear Drainage over a 12-Year Period (1999–2010) in a Region of Northern Spain</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33726521" href="https://metaaprendizaje.academia.edu/EDUARDOGPEREZYARZA">EDUARDO G PEREZ-YARZA</a></div><p class="ds-related-work--metadata ds2-5-body-xs">PLoS ONE, 2013</p><p class="ds-related-work--abstract ds2-5-body-sm">The aim of this study was to determine the serotype and clonal distribution of pneumococci causing acute otitis media (AOM) and their relationship with recurrences and mixed infections with other microorganisms under the influence of the 7valent pneumococcal conjugate vaccine (PCV7). To do this, all pneumococcal isolates collected from the spontaneous middle-ear drainage of children ,5 years old diagnosed of AOM by their pediatrician or their general practitioner from 1999 to 2010 were phenotypically characterized and the most frequent serotypes were genotyped. In the 12-year study, 818 episodes of pneumococcal AOM were detected, mostly (70.5%) in children younger than 2 years old. In 262 episodes (32%), the pneumococci were isolated with another bacterium, mainly (n = 214) Haemophilus influenzae. Mixed infections were similar in children under or over 2 years old. The most frequent serotypes were 19A (n = 227, 27.8%), 3 (n = 92, 11.2%) and 19F (n = 74, 9%). Serotypes included in the PCV7 sharply decreased from 62.4% in the pre-vaccination (1999-2001) to 2.2% in the late post-vaccination period (2008)(2009)(2010). Serotype diversity steadily increased after the introduction of the PCV7 but decreased from 2008-2010 due to the predominant role of serotype 19A isolates, mostly ST276 and ST320. The prevalence of serotype 3 doubled from 6.1% (20/326) in 1999-2004 to 14.6% (72/492) in 2005-2010. Relapses mainly occurred in male infants infected with isolates with diminished antimicrobial susceptibility. Reinfections caused by isolates with the same serotype but different genotype were frequent, highlighting the need for genetic studies to differentiate among similar strains. In conclusion, the main change in pneumococcal AOM observed after the introduction of the PCV7 was the sharp decrease in vaccine serotypes. Also notable was the high burden of serotype 19A in total pneumococcal AOM before and especially after the introduction of the PCV7, as well as in relapses and reinfections.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Dynamics of Streptococcus pneumoniae Serotypes Causing Acute Otitis Media Isolated from Children with Spontaneous Middle-Ear Drainage over a 12-Year Period (1999–2010) in a Region of Northern Spain","attachmentId":43911440,"attachmentType":"pdf","work_url":"https://www.academia.edu/14759612/Dynamics_of_Streptococcus_pneumoniae_Serotypes_Causing_Acute_Otitis_Media_Isolated_from_Children_with_Spontaneous_Middle_Ear_Drainage_over_a_12_Year_Period_1999_2010_in_a_Region_of_Northern_Spain","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/14759612/Dynamics_of_Streptococcus_pneumoniae_Serotypes_Causing_Acute_Otitis_Media_Isolated_from_Children_with_Spontaneous_Middle_Ear_Drainage_over_a_12_Year_Period_1999_2010_in_a_Region_of_Northern_Spain"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="3" data-entity-id="107372851" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/107372851/The_effect_of_immunization_with_pneumococcal_conjugated_vaccines_on_Streptococcus_pneumoniae_resistance_patterns_in_acute_otitis_media">The effect of immunization with pneumococcal conjugated vaccines on Streptococcus pneumoniae resistance patterns in acute otitis media</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="32700344" href="https://telaviv.academia.edu/SharonTamir">Sharon Tamir</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Microbiology, Immunology and Infection, 2017</p><p class="ds-related-work--abstract ds2-5-body-sm">Following the introduction of 7-and 13-pneumococcal conjugate vaccines (PCVs) in Israel, we demonstrated that within Streptococcus pneumoniae (Sp) positive middle ear cultures, obtained from young children with severe acute otitis media (AOM) episodes, there were more penicillin-susceptible and less multi-drug resistant Sp isolates in PCV immunized children.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"The effect of immunization with pneumococcal conjugated vaccines on Streptococcus pneumoniae resistance patterns in acute otitis media","attachmentId":106056323,"attachmentType":"pdf","work_url":"https://www.academia.edu/107372851/The_effect_of_immunization_with_pneumococcal_conjugated_vaccines_on_Streptococcus_pneumoniae_resistance_patterns_in_acute_otitis_media","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/107372851/The_effect_of_immunization_with_pneumococcal_conjugated_vaccines_on_Streptococcus_pneumoniae_resistance_patterns_in_acute_otitis_media"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="4" data-entity-id="19104267" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/19104267/Characterization_of_Streptococcus_pneumoniae_isolated_from_children_with_otitis_media">Characterization of Streptococcus pneumoniae isolated from children with otitis media</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="39286905" href="https://independent.academia.edu/CourtneyShires">Courtney Shires</a></div><p class="ds-related-work--metadata ds2-5-body-xs">FEMS Immunology & Medical Microbiology, 2007</p><p class="ds-related-work--abstract ds2-5-body-sm">Streptococcus pneumoniae is the main causative agent of acute otitis media in children. Serotype-based vaccines have provided some protection against otitis media, but not as much as anticipated, demonstrating the need for alternative vaccine options. Pneumococcal otitis media isolates were obtained from children 5 years old or younger from hospitals around Mississippi in the prevaccine era (1999)(2000). These isolates were compared by capsular typing, pneumococcal surface protein A (PspA) family typing, antibiotic susceptibility, and DNA fingerprinting. Our study shows that there is great genetic variability among pneumococcal clinical isolates of otitis media, except with regard to PspA. Therefore, efforts focused on the development of a PspA-based pneumococcal vaccine would be well placed.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Characterization of Streptococcus pneumoniae isolated from children with otitis media","attachmentId":42110219,"attachmentType":"pdf","work_url":"https://www.academia.edu/19104267/Characterization_of_Streptococcus_pneumoniae_isolated_from_children_with_otitis_media","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/19104267/Characterization_of_Streptococcus_pneumoniae_isolated_from_children_with_otitis_media"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="5" data-entity-id="86562918" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/86562918/Serotype_distribution_and_antimicrobial_susceptibility_of_Streptococcus_pneumoniae_causing_invasive_infections_and_acute_otitis_media_in_children">Serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae causing invasive infections and acute otitis media in children</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="30984140" href="https://dmrlm.academia.edu/wahwahAung">wah wah Aung</a></div><p class="ds-related-work--metadata ds2-5-body-xs">European Journal of Pediatrics, 2004</p><p class="ds-related-work--abstract ds2-5-body-sm">A prospective study was conducted to determine the serotypes and antibiotic resistance patterns of pneumococcal isolates from children with invasive pneumococcal disease (IPD) and acute otitis media (AOM). From October 2001 to May 2002, 65 children with IPD (28 bacteraemic pneumonia, 24 bacteraemia without focus, 7 meningitis, 6 other infections) and 78 with AOM were identified. The most common serotypes causing IPD were 14 (32.3%), 6B (20.0%), 1 (18.5%) and 19F (7.7%) whereas the predominant serotypes causing AOM were 19F (35.9%), 14 (16.7%) and 23F (9.1%). Sixty-nine percent of IPD and 70.5% of AOM were caused by vaccine serotypes. The vaccine serotypes were more commonly encountered in meningitis cases and in children younger than 2 years of age. Intermediate resistance to penicillin was observed in 6 of 65 (9.2%) IPD isolates, one of which was intermediately resistant to cefotaxime (1.6%), whereas none exhibited high-level resistance to penicillin or other beta-lactam antibiotics. A higher proportion of antimicrobial resistance was noted in AOM isolates; 29 of 78 (37.4%) exhibited intermediate resistance and 8 (10.2%) high level resistance to penicillin, four of which had intermediate resistance to cefotaxime. Significant resistance was also noted to erythromycin; 38.5% of IPD and 48.7% of AOM isolates were resistant. Multidrug resistance was observed in one IPD and in eight AOM isolates. Conclusion: These findings have implications in the potential use of 7-valent conjugate vaccine in our region.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae causing invasive infections and acute otitis media in children","attachmentId":90987046,"attachmentType":"pdf","work_url":"https://www.academia.edu/86562918/Serotype_distribution_and_antimicrobial_susceptibility_of_Streptococcus_pneumoniae_causing_invasive_infections_and_acute_otitis_media_in_children","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/86562918/Serotype_distribution_and_antimicrobial_susceptibility_of_Streptococcus_pneumoniae_causing_invasive_infections_and_acute_otitis_media_in_children"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="6" data-entity-id="55211499" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/55211499/Serotype_distribution_of_pneumococci_isolated_from_pediatric_patients_with_acute_otitis_media_and_invasive_infections_and_potential_coverage_of_pneumococcal_conjugated_vaccines">Serotype distribution of pneumococci isolated from pediatric patients with acute otitis media and invasive infections, and potential coverage of pneumococcal conjugated vaccines</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="43708708" href="https://independent.academia.edu/ClaudiaHern%C3%A1ndez28">Claudia Hernández</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Revista Argentina de microbiología</p><p class="ds-related-work--abstract ds2-5-body-sm">A 16-month prospective, descriptive study was conducted on pneumococcal serotype distribution isolated from children with acute otitis media (AOM) and invasive infections (INV). Eighty-nine children with pneumococcal INV and 324 with a first episode of AOM were included. Bacterial pathogens (N = 326) were isolated from the middle-ear fluid of 250 patients. A total of 30 pneumococcal serotypes were identified. Prevalent serotypes were 14, 19A, 9V, 3, 19F, 6A, 23F, and 18C in AOM and 14, 1, 19A, 5, 12F, 6B, and 18C in INV. Potential coverage with PCV10 vaccine would be 46.5 % and 60.7 % for pneumococci involved in AOM and INV, respectively; it would be 71.7 % and 73 % with PCV13. PCV10, conjugated with a Haemophilus protein, would have an immunologic coverage of 39.9 % for AOM vs. 18.5 % with PCV13. However, differences in the prevention of INV were crucial for the decision to include the 13-valent vaccine in the national calendar for children less than two years old in Argentina.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Serotype distribution of pneumococci isolated from pediatric patients with acute otitis media and invasive infections, and potential coverage of pneumococcal conjugated vaccines","attachmentId":71190030,"attachmentType":"pdf","work_url":"https://www.academia.edu/55211499/Serotype_distribution_of_pneumococci_isolated_from_pediatric_patients_with_acute_otitis_media_and_invasive_infections_and_potential_coverage_of_pneumococcal_conjugated_vaccines","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/55211499/Serotype_distribution_of_pneumococci_isolated_from_pediatric_patients_with_acute_otitis_media_and_invasive_infections_and_potential_coverage_of_pneumococcal_conjugated_vaccines"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="7" data-entity-id="68839411" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/68839411/Pneumococcal_acute_otitis_media_in_infants_and_children_in_central_Romania_2009_2011_microbiological_characteristics_and_potential_coverage_by_pneumococcal_conjugate_vaccines">Pneumococcal acute otitis media in infants and children in central Romania, 2009–2011: microbiological characteristics and potential coverage by pneumococcal conjugate vaccines</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="32346115" href="https://bgu.academia.edu/EugeneLeibovitz">Eugene Leibovitz</a></div><p class="ds-related-work--metadata ds2-5-body-xs">International Journal of Infectious Diseases, 2013</p><p class="ds-related-work--abstract ds2-5-body-sm">Acute otitis media (AOM) is the most frequent bacterial disease of childhood, affecting millions of children worldwide and remaining a major public health problem. 1-3 The most common causative agents in AOM are Streptococcus pneumoniae, nontypeable Haemophilus influenzae (NTHi), Moraxella catarrhalis, and Streptococcus pyogenes. 4-8 Together, S. pneumoniae and NTHi account for 60-80% of the AOM pathogens. 9 Antibiotic resistance is high in pneumococcal AOM, with penicillin-and amoxicillinnon-susceptible strains accounting for 30-70% of cases. 10-16 The most commonly encountered S. pneumoniae serotypes in AOM are 6A, 6B, 14, 19A, 19F, and 23F. 15,16 The highest antibiotic nonsusceptibility is found in vaccine serotypes 6A, 6B, 9 V, 14, 19A, 19F, and 23F. 11,12,15,16 Information on antibiotic resistance patterns and serotype distribution of S. pneumoniae isolates in infants and young children in Romania is limited. In a multinational study, 42% of S. pneumoniae AOM isolates from Romania were intermediately or fully resistant to penicillin. 17 In three studies investigating pneumococcal mucosal and invasive disease isolates in HIVnegative and HIV-positive infants and children in northeastern</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Pneumococcal acute otitis media in infants and children in central Romania, 2009–2011: microbiological characteristics and potential coverage by pneumococcal conjugate vaccines","attachmentId":79170836,"attachmentType":"pdf","work_url":"https://www.academia.edu/68839411/Pneumococcal_acute_otitis_media_in_infants_and_children_in_central_Romania_2009_2011_microbiological_characteristics_and_potential_coverage_by_pneumococcal_conjugate_vaccines","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/68839411/Pneumococcal_acute_otitis_media_in_infants_and_children_in_central_Romania_2009_2011_microbiological_characteristics_and_potential_coverage_by_pneumococcal_conjugate_vaccines"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="8" data-entity-id="68839430" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/68839430/The_impact_of_the_widespread_introduction_of_pneumococcal_conjugate_vaccines_on_pneumococcal_and_non_pneumococcal_otitis_media">The impact of the widespread introduction of pneumococcal conjugate vaccines on pneumococcal and non-pneumococcal otitis media</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="32346115" href="https://bgu.academia.edu/EugeneLeibovitz">Eugene Leibovitz</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2016</p><p class="ds-related-work--abstract ds2-5-body-sm">The pneumococcal conjugated vaccines (PCVs) impact on complex otitis media (including recurrent, non-responsive, spontaneously draining and chronic OM with effusion) was greater than that against simple, acute-OM in previous studies. Since complex OM is often a polymicrobial disease, we speculated that reduction of complex OM by PCVs will be associated in addition with reduction of non-pneumococcal OM. In a prospective, population-based, active surveillance, all OM episodes submitted for middle ear fluid (MEF) culture in children &lt;3 years, during 2004-2015 were included. Three sub-periods were defined: pre-PCV, PCV7, and PCV13 periods. Incidence rate ratios (IRRs) comparing the three periods were calculated for pneumococcal, non-typeable Haemophilus influenzae (NTHi), Moraxella catarrhalis, Streptococcus pyogenes and culture-negative OM. Overall, 7,475 episodes were included. Of all NTHi cases in the pre-PCV period, 34% were mixed with Streptococcus pneumoniae IRRs (95% confid...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"The impact of the widespread introduction of pneumococcal conjugate vaccines on pneumococcal and non-pneumococcal otitis media","attachmentId":79170842,"attachmentType":"pdf","work_url":"https://www.academia.edu/68839430/The_impact_of_the_widespread_introduction_of_pneumococcal_conjugate_vaccines_on_pneumococcal_and_non_pneumococcal_otitis_media","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/68839430/The_impact_of_the_widespread_introduction_of_pneumococcal_conjugate_vaccines_on_pneumococcal_and_non_pneumococcal_otitis_media"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="9" data-entity-id="16546853" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/16546853/Microbiological_characterization_of_Streptococcus_pneumoniae_and_non_typeable_Haemophilus_influenzae_isolates_as_primary_causes_of_acute_otitis_media_in_Bulgarian_children_before_the_introduction_of_conjugate_vaccines">Microbiological characterization of Streptococcus pneumoniae and non-typeable Haemophilus influenzae isolates as primary causes of acute otitis media in Bulgarian children before the introduction of conjugate vaccines</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="35976275" href="https://independent.academia.edu/AlexandraAlexandrova3">Alexandra Alexandrova</a><span>, </span><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="36127066" href="https://independent.academia.edu/DimitarNashev">Dimitar Nashev</a><span>, </span><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="35828355" href="https://independent.academia.edu/TKostyanev">T. Kostyanev</a><span>, </span><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="37781746" href="https://independent.academia.edu/LenaSetchanova">Lena Setchanova</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Annals of Clinical Microbiology and Antimicrobials, 2013</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Microbiological characterization of Streptococcus pneumoniae and non-typeable Haemophilus influenzae isolates as primary causes of acute otitis media in Bulgarian children before the introduction of conjugate vaccines","attachmentId":42441845,"attachmentType":"pdf","work_url":"https://www.academia.edu/16546853/Microbiological_characterization_of_Streptococcus_pneumoniae_and_non_typeable_Haemophilus_influenzae_isolates_as_primary_causes_of_acute_otitis_media_in_Bulgarian_children_before_the_introduction_of_conjugate_vaccines","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/16546853/Microbiological_characterization_of_Streptococcus_pneumoniae_and_non_typeable_Haemophilus_influenzae_isolates_as_primary_causes_of_acute_otitis_media_in_Bulgarian_children_before_the_introduction_of_conjugate_vaccines"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div></div></div><div class="ds-sticky-ctas--wrapper js-loswp-sticky-ctas hidden"><div class="ds-sticky-ctas--grid-container"><div class="ds-sticky-ctas--container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--sticky-ctas","attachmentId":74083199,"attachmentType":"pdf","workUrl":null}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--sticky-ctas","attachmentId":74083199,"attachmentType":"pdf","workUrl":null}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div></div></div><div class="ds-below-fold--grid-container"><div class="ds-work--container js-loswp-embedded-document"><div class="attachment_preview" data-attachment="Attachment_74083199" style="display: none"><div class="js-scribd-document-container"><div class="scribd--document-loading js-scribd-document-loader" style="display: block;"><img alt="Loading..." src="//a.academia-assets.com/images/loaders/paper-load.gif" /><p>Loading Preview</p></div></div><div style="text-align: center;"><div class="scribd--no-preview-alert js-preview-unavailable"><p>Sorry, preview is currently unavailable. You can download the paper by clicking the button above.</p></div></div></div></div><div class="ds-sidebar--container js-work-sidebar"><div class="ds-related-content--container"><h2 class="ds-related-content--heading">Related papers</h2><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="0" data-entity-id="63833947" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/63833947/Higher_levels_of_mucosal_antibody_to_pneumococcal_vaccine_candidate_proteins_are_associated_with_reduced_acute_otitis_media_caused_by_Streptococcus_pneumoniae_in_young_children">Higher levels of mucosal antibody to pneumococcal vaccine candidate proteins are associated with reduced acute otitis media caused by Streptococcus pneumoniae in young children</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" 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PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/63833947/Higher_levels_of_mucosal_antibody_to_pneumococcal_vaccine_candidate_proteins_are_associated_with_reduced_acute_otitis_media_caused_by_Streptococcus_pneumoniae_in_young_children"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="1" data-entity-id="68078607" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/68078607/Serotype_distribution_and_antimicrobial_susceptibilities_of_nasopharyngeal_isolates_of_Streptococcus_pneumoniae_from_healthy_children_in_the_13_valent_pneumococcal_conjugate_vaccine_era">Serotype distribution and antimicrobial susceptibilities of nasopharyngeal isolates of Streptococcus pneumoniae from healthy children in the 13-valent pneumococcal conjugate vaccine era</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="114373221" href="https://independent.academia.edu/MarinaCamiletti">Marina Camiletti</a></div><p class="ds-related-work--metadata ds2-5-body-xs">2014</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Serotype distribution and antimicrobial susceptibilities of nasopharyngeal isolates of Streptococcus pneumoniae from healthy children in the 13-valent pneumococcal conjugate vaccine era","attachmentId":78684136,"attachmentType":"pdf","work_url":"https://www.academia.edu/68078607/Serotype_distribution_and_antimicrobial_susceptibilities_of_nasopharyngeal_isolates_of_Streptococcus_pneumoniae_from_healthy_children_in_the_13_valent_pneumococcal_conjugate_vaccine_era","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/68078607/Serotype_distribution_and_antimicrobial_susceptibilities_of_nasopharyngeal_isolates_of_Streptococcus_pneumoniae_from_healthy_children_in_the_13_valent_pneumococcal_conjugate_vaccine_era"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="2" data-entity-id="117092949" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/117092949/Pneumococcal_Conjugate_Vaccine_Does_Not_Influence_Staphylococcus_aureus_Carriage_in_Young_Children_with_Acute_Otitis_Media">Pneumococcal Conjugate Vaccine Does Not Influence Staphylococcus aureus Carriage in Young Children with Acute Otitis Media</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="257906263" href="https://independent.academia.edu/FranckThollot">Franck Thollot</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Clinical Infectious Diseases, 2007</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" 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translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="3" data-entity-id="72896717" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/72896717/Nasopharyngeal_Carriage_of_Streptococcus_pneumoniae_in_Healthy_Children_Implications_for_the_Use_of_Heptavalent_Pnemococcal_Conjugate_Vaccine">Nasopharyngeal Carriage of Streptococcus pneumoniae in Healthy Children: Implications for the Use of Heptavalent Pnemococcal Conjugate Vaccine</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="32636281" href="https://independent.academia.edu/NicolaPrincipi">Nicola Principi</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Emerging Infectious Diseases, 2002</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link 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ds2-5-body-xs">The Journal of Infectious Diseases, 2000</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Acute Otitis Media Caused by Antibiotic‐Resistant Streptococcus pneumoniae in Southern Israel: Implication for Immunizing with Conjugate Vaccines","attachmentId":53189417,"attachmentType":"pdf","work_url":"https://www.academia.edu/33089738/Acute_Otitis_Media_Caused_by_Antibiotic_Resistant_Streptococcus_pneumoniae_in_Southern_Israel_Implication_for_Immunizing_with_Conjugate_Vaccines","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" 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data-collection-position="11" data-entity-id="52772981" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/52772981/Predominance_of_nontypeable_Haemophilus_influenzae_in_children_with_otitis_media_following_introduction_of_a_3_0_pneumococcal_conjugate_vaccine_schedule">Predominance of nontypeable Haemophilus influenzae in children with otitis media following introduction of a 3+0 pneumococcal conjugate vaccine schedule</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="35895386" href="https://uwa.academia.edu/ShyanVijayasekaran">Shyan Vijayasekaran</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Vaccine, 2011</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" 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