{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:01:00Z","timestamp":1790190060336,"version":"4.1.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Investigator-Initiated Studies Program of MSD Italia","award":["IIS61342"],"award-info":[{"award-number":["IIS61342"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Italy, evidence on the long-term effects of pneumococcal conjugate vaccines on nasopharyngeal carriage is still limited. This study assessed pneumococcal carriage prevalence, serotype distribution, and temporal trends during the decade after 13-valent pneumococcal conjugate vaccine (PCV13) introduction and before the severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Oropharyngeal samples were collected from 12 733 individuals of all ages presenting with influenza-like illness within the national respiratory pathogens surveillance network. Streptococcus pneumoniae detection and serotyping were performed using real-time PCR-based assays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall pneumococcal carriage was 27.1%. The highest prevalence occurred in children aged 2\u20134 years (51.6%), while colonization was about 10% among adults, including those \u226575 years. After vaccine introduction, PCV serotypes declined markedly, accompanied by increased nonvaccine serotypes. Following years of sustained pediatric vaccination, vaccine serotypes re-emerged, replacing previously expanding non-PCV types. Some vaccine serotypes associated with higher invasive disease risk persisted despite high vaccination coverage. Serotype distribution differed significantly by age, and viral coinfection\u2013especially hRSV\u2013appeared to increase pneumococcal colonization likelihood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pneumococcal carriage remained common across all ages despite long-standing pediatric vaccination, with continued circulation of both vaccine and nonvaccine serotypes. Viral coinfection may facilitate colonization, highlighting the need for ongoing surveillance and adaptive vaccination strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiag150","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T12:54:05Z","timestamp":1772628845000},"page":"e690-e701","source":"Crossref","is-referenced-by-count":2,"title":["Indirect Effect of Pneumococcal Conjugate Vaccines on Pneumococcal Colonization: Persistence and Dynamics of Vaccine Serotypes in Sicily (Italy) 11 Years Postintroduction, 2009\u20132020"],"prefix":"10.1093","volume":"234","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0108-4608","authenticated-orcid":false,"given":"Fabio","family":"Tramuto","sequence":"first","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties \u201cG. D\u2019Alessandro\u201d\u2014Hygiene Section, University of Palermo , Palermo ,","place":["Italy"]},{"name":"Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital \u201cPaolo Giaccone\u201d , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1139-0879","authenticated-orcid":false,"given":"Giulia","family":"Randazzo","sequence":"additional","affiliation":[{"name":"Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital \u201cPaolo Giaccone\u201d , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3540-4316","authenticated-orcid":false,"given":"Arianna","family":"Santino","sequence":"additional","affiliation":[{"name":"Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital \u201cPaolo Giaccone\u201d , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5665-9683","authenticated-orcid":false,"given":"Giuseppe","family":"Sferlazza","sequence":"additional","affiliation":[{"name":"Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital \u201cPaolo Giaccone\u201d , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5501-9687","authenticated-orcid":false,"given":"Adriana","family":"Previti","sequence":"additional","affiliation":[{"name":"Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital \u201cPaolo Giaccone\u201d , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5851-5256","authenticated-orcid":false,"given":"Giorgio","family":"Graziano","sequence":"additional","affiliation":[{"name":"Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital \u201cPaolo Giaccone\u201d , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3397-7331","authenticated-orcid":false,"given":"Claudio","family":"Costantino","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties \u201cG. D\u2019Alessandro\u201d\u2014Hygiene Section, University of Palermo , Palermo ,","place":["Italy"]},{"name":"Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital \u201cPaolo Giaccone\u201d , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5090-1366","authenticated-orcid":false,"given":"Walter","family":"Mazzucco","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties \u201cG. D\u2019Alessandro\u201d\u2014Hygiene Section, University of Palermo , Palermo ,","place":["Italy"]},{"name":"Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital \u201cPaolo Giaccone\u201d , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5482-5268","authenticated-orcid":false,"given":"Emanuele","family":"Amodio","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties \u201cG. 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D\u2019Alessandro\u201d\u2014Hygiene Section, University of Palermo , Palermo ,","place":["Italy"]},{"name":"Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital \u201cPaolo Giaccone\u201d , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6989-9259","authenticated-orcid":false,"given":"Carmelo Massimo","family":"Maida","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties \u201cG. 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