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We investigated the epidemiology of\n                      <jats:italic>S. pneumoniae<\/jats:italic>\n                      in a pediatric fever clinic and explored the genomics basis of the limited vaccine response of serotype 14 strains worldwide.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Febrile disease and pneumonia were diagnosed following criteria from the WHO at the end of 2019 at a tertiary children\u2019s hospital. Spn was isolated by culture from nasopharyngeal (NP) swabs. The density was determined by\n                      <jats:italic>lytA<\/jats:italic>\n                      -base qPCR. Isolates were serotyped by Quellung and underwent antimicrobial susceptibility testing. Whole-genome sequencing was employed for molecular serotyping, MLST, antibiotic gene determination, SNP calling, recombination prediction, and phylogenetic analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The presence of pneumococcus in the nasopharynx (87.5%, 7\/8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0227) and a high carriage (100%, 7\/7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0123) were significantly associated with pneumonia development. Living with siblings (73.7%, 14\/19,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0125) and non-vaccination (56.0%, 28\/50,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0377) contributed significantly to the Spn carriage. Serotype 14 was the most prevalent strain (16.67%, 5\/30). The genome analysis of 1497 serotype 14 strains indicated S14\/ST876 strains were only prevalent in China, presented limited vaccine responses with higher recombination activities within its\n                      <jats:italic>cps<\/jats:italic>\n                      locus, and unique variation patterns in the genes\n                      <jats:italic>wzg<\/jats:italic>\n                      and\n                      <jats:italic>lrp<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      With the lifting of the one-child policy, it will be crucial for families with multiple children to get PCV vaccinations in China. Due to the highly variant\n                      <jats:italic>cps<\/jats:italic>\n                      locus and distinctive variation patterns in capsule shedding and binding proteins genes, the prevalent S14\/ST876 strains have shown poor response to current vaccines. It is necessary to continue monitoring the molecular epidemiology of this vaccine escape clone.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-023-02110-y","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T15:02:13Z","timestamp":1698937333000},"page":"801-811","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Limited protection of pneumococcal vaccines against emergent Streptococcus pneumoniae serotype 14\/ST876 strains"],"prefix":"10.1007","volume":"52","author":[{"given":"Yinle","family":"Lan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongping","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihong","family":"Ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Xiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minfei","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuxian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuexing","family":"Tu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge E.","family":"Vidal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunsong","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhimin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueqing","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,2]]},"reference":[{"key":"2110_CR1","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1016\/S0140-6736(21)00883-7","volume":"398","author":"D van de Beek","year":"2021","unstructured":"van de Beek D, Brouwer MC, Koedel U, Wall EC. 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