{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:56:07Z","timestamp":1790812567662,"version":"4.1.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T00:00:00Z","timestamp":1594339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","award":["0887X1-4603"],"award-info":[{"award-number":["0887X1-4603"]}],"id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In the pre-pneumococcal conjugated vaccines (PCVs) era, serotypes included in the 7\/13-valent PCVs (PCV7\/PCV13) caused most pneumococcal otitis media (OM) and antibiotic-non-susceptible pneumococcal OM (ANSP-OM) episodes. In southern Israel, sequential PCV7\/PCV13 introduction resulted in &amp;gt;90% reduction of vaccine-serotype OM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We assessed the dynamics of ANSP-OM necessitating middle ear fluid culture following PCV7\/PCV13 sequential introduction in young children.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a prospective, population-based, active surveillance. All episodes in children &amp;lt;3\u2009years old, during 2004\u201316, were included. Two subperiods were defined: (i) pre-PCV: 2004\u201308; and (ii) PCV13: 2014\u201316. ANSP was defined for the following antibiotics: penicillin (MIC \u22650.1\u2009mg\/L and \u22651.0\u2009mg\/L), macrolide, tetracycline, clindamycin, ceftriaxone, trimethoprim\/sulfamethoxazole and chloramphenicol. MDR was defined as ANSP for \u22653 classes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 2270 pneumococcal OM episodes were identified. Annual overall pneumococcal, PCV13 and non-PCV13 serotype OM incidence declined by 86%, 97% and 33%, respectively, comparing pre-PCV with the PCV13 period. During 2004\u201308, 95% of ANSP was observed in vaccine serotypes. Incidence of penicillin (MIC \u22650.1\u2009mg\/L and \u22651.0\u2009mg\/L), macrolide, tetracycline, clindamycin, ceftriaxone and multidrug ANSP-OM declined by &amp;gt;90% in the PCV13 period. Rates of trimethoprim\/sulfamethoxazole and chloramphenicol ANSP-OM declined by 85% and 79%, respectively. The proportions of ANSP of all pneumococcal isolates declined by \u223c70% for penicillin, ceftriaxone and erythromycin; 53% for tetracycline; and 55% for MDR, versus no significant reductions observed for chloramphenicol, trimethoprim\/sulfamethoxazole and clindamycin.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>PCV7\/PCV13 sequential introduction resulted in rapid and substantial ANSP-OM reduction, in parallel with the near disappearance of PCV13-serotype OM and no increase in replacement disease.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkaa263","type":"journal-article","created":{"date-parts":[[2020,5,31]],"date-time":"2020-05-31T11:06:54Z","timestamp":1590923214000},"page":"3038-3045","source":"Crossref","is-referenced-by-count":10,"title":["Substantial reduction of antibiotic-non-susceptible pneumococcal otitis media following PCV7\/PCV13 sequential introduction"],"prefix":"10.1093","volume":"75","author":[{"given":"Shalom","family":"Ben-Shimol","sequence":"first","affiliation":[{"name":"The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noga","family":"Givon-Lavi","sequence":"additional","affiliation":[{"name":"The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Greenberg","sequence":"additional","affiliation":[{"name":"The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart Adriaan","family":"van der Beek","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Leibovitz","sequence":"additional","affiliation":[{"name":"The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8888-1046","authenticated-orcid":false,"given":"Ron","family":"Dagan","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, 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