{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T08:11:33Z","timestamp":1776759093408,"version":"3.51.2"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006191","name":"Eskisehir Osmangazi University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006191","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    After the widespread use of pneumococcal conjugated vaccines (PCVs), pneumococcal carriage, especially due to some vaccine serotypes, has been shown to decrease, but carriage with non-vaccine serotypes and some persistent vaccine types of lineages has been demonstrated to continue. Evaluation of pneumococcal carriage helps to understand disease epidemiology. In this multicenter study, we aimed to determine pneumococcal carriage and serotype distribution in children, adolescents, and young adults aged 0\u201324\u00a0years in T\u00fcrkiye after the pandemic era. This multicenter study was conducted between April and August 2022 in 1585 healthy children, adolescents, and young adults (aged between 0 and 24\u00a0years) in nine centers in T\u00fcrkiye. Demographics, schooling\/day\u2011care, smoking exposure, recent upper respiratory tract infection (URTI), antibiotic use (1 and 3\u00a0months), COVID\u201119 infection\/vaccination, and pneumococcal vaccination history were recorded. Nasopharyngeal swab samples were taken from all participants.\n                    <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                    was detected by real\u2011time polymerase chain reaction (PCR); positives were serotyped by singleplex real\u2011time PCR assays targeting 33 serotypes\/serogroups. Among 1 585 participants (797 female; age distribution 0\u20135\u00a0years 22.0%, 6\u201310\u00a0years 29.3%, 11\u201315\u00a0years 16.8%, 16\u201318\u00a0years 12.9%, 19\u201324\u00a0years 19.0%), overall pneumococcal carriage prevalence was 19.6% (311\/1 585). Age\u2011specific prevalences were 20.7% (0\u20135\u00a0years), 21.8% (6\u201310\u00a0years; peak), 19.1% (11\u201315\u00a0years), 15.6% (16\u201318\u00a0years), and 18.2% (19\u201324\u00a0years). Two\u2011thirds (66.2%) had received\u2009\u2265\u20091 PCV dose (coverage\u2009\u2265\u200982% through 15\u00a0years, declining to 43.9% at 16\u201318\u00a0years and 13.3% at 19\u201324\u00a0years). Vaccination was associated with significantly lower carriage only in children\u2009\u2264\u200910\u00a0years: 0\u20135\u00a0years 17.8% vs 43.6% (OR 0.28, 95% CI 0.13\u20130.60,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001); 6\u201310\u00a0years 19.7% vs 32.4% (OR 0.51, 0.28\u20130.93,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.021). No significant differences were seen in older strata or overall (18.8% vs 21.3%, OR 0.85, 0.65\u20131.12). Of 311 isolates, 225 (72.4%) were typed (27 serotypes) and 86 (27.6%) were not defined. Dominant serotypes were 19F, 6A\/B, 3, 23F, and 15B\/C; PCV13 serotypes comprised 77.3% of typed isolates. Theoretical vaccine coverage among 225 typed isolates increased from 61\u201364% (PCV7\/10) to 77.3% (PCV13), 78.2% (PCV15), 88.4\u201390.2% (PCV20\/24), plateauing at 93.3\u201393.8% for PCV31\/25. Theoretical vaccine coverage in children aged below 5\u00a0years of age was 66.7% for PCV13, 70.0% for PCV15, and 88.3% for PCV20. The frequency of PCV13 serotypes in children vaccinated with PCV13 was significantly lower than in unvaccinated children in children below 5\u00a0years of age.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion<\/jats:italic>\n                    : Post\u2011pandemic pneumococcal carriage in T\u00fcrkiye remains 19.6% across childhood. Direct protection against nasopharyngeal carriage was evident in children\u2009\u2264\u200910 y. Higher\u2011valency PCVs and enhanced genomic serotype surveillance are needed to address residual carriage and guide future immunization strategies.\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td align=\"left\">\n                              <jats:bold>What is Known:<\/jats:bold>\n                              \u2022\u00a0\n                              <jats:italic>Pneumococcal conjugate vaccines (PCVs) have substantially reduced invasive pneumococcal disease, but nasopharyngeal\u00a0<\/jats:italic>\n                              <jats:italic>colonization persists due to serotype replacement.<\/jats:italic>\n                              \u2022\u00a0\n                              <jats:italic>After the COVID-19 pandemic, major shifts in respiratory pathogen epidemiology occurred, yet contemporary post-pandemic\u00a0<\/jats:italic>\n                              <jats:italic>data on pneumococcal carriage and serotype distribution remain scarce.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td align=\"left\">\n                              <jats:bold>What is New:<\/jats:bold>\n                              \u2022\u00a0\n                              <jats:italic>This is the first multicenter post-COVID pneumococcal carriage study in T\u00fcrkiye covering the full 0\u201324-year age spectrum,\u00a0<\/jats:italic>\n                              <jats:italic>showing that carriage remains stable at ~20%.<\/jats:italic>\n                              \u2022\u00a0\n                              <jats:italic>Direct vaccine protection against carriage is confined to children \u226410 years, with no measurable impact in adolescents or young\u00a0<\/jats:italic>\n                              <jats:italic>adults. Some vaccine serotypes and non-vaccine serotypes still dominate carriage, and higher-valency PCVs would markedly\u00a0<\/jats:italic>\n                              <jats:italic>improve theoretical coverage.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-026-06744-6","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T07:45:20Z","timestamp":1769067920000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Nasopharyngeal pneumococcal carriage and serotype landscape in children, adolescents and young adults in T\u00fcrkiye"],"prefix":"10.1007","volume":"185","author":[{"given":"Mahmut Can","family":"Kizil","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omer","family":"Kilic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yalcin","family":"Kara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mucahit","family":"Kaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adem","family":"Karbuz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merve","family":"Iseri Nepesov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ergin","family":"Ciftci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Halil","family":"Ozdemir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatma Nur","family":"Oz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zafer","family":"Kurugol","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Solmaz","family":"Celebi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benhur Sirvan","family":"Cetin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilek","family":"Yilmaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meltem","family":"Dinleyici","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didem","family":"Kizmaz Isancli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onder","family":"Kilicaslan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabia G.","family":"Sezer Yamanel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Belk\u0131s Hatice","family":"Inceli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dondu Nilay","family":"Penezoglu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burce","family":"Dortkardesler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatma Dilsad","family":"Aksoy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sedanur","family":"Tekin Can","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nesli","family":"Agrali Eroz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ener Cagri","family":"Dinleyici","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"6744_CR1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.22341.1","volume":"9","author":"C Feldman","year":"2020","unstructured":"Feldman C, Anderson R (2020) Recent advances in the epidemiology and prevention of Streptococcus pneumoniae infections. 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