{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:58:40Z","timestamp":1790935120433,"version":"4.1.0"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Since the introduction of pediatric pneumococcal conjugate vaccines were introduced in the US in 2000, acute respiratory illnesses, including acute otitis media (AOM) due to Streptococcus pneumoniae (Spn), have declined. Pathogens associated with AOM have changed over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children aged 6 through 35\u00a0months diagnosed with either AOM (Cohort 1\u2014AOM with tympanocentesis &amp; Cohort 2\u2014AOM without tympanocentesis) or upper respiratory infection (URI) without AOM (Cohort 3) were concurrently enrolled in Pittsburgh, PA. Nasal specimens were collected for all children. Middle ear fluid (MEF) specimens were obtained by tympanocentesis for children in Cohort 1. MEF and nasal specimens were tested for Spn, Haemophilus influenzae (Hflu), and Moraxella catarrhalis (Mcat). Serotypes (Spn) and susceptibility (Spn and Hflu) were determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From October 2019 through August 2023, 451 children were enrolled (Cohort 1: n\u2009=\u200957; Cohort 2: n\u2009=\u2009262; Cohort 3: n\u2009=\u2009132). For bacterial testing of MEF, 45\/57 (79%) had a single pathogen detected. Pathogens detected, alone or in combination in the MEF were Hflu 32\/57 (56%), Mcat 13\/57 (23%), and Spn 12\/57 (21%). Of participants with bacterial pathogens detected in the MEF, there was only modest concordance with the pathogens detected in the nose. Spn serotypes observed in MEF were 3, 11A, 15B, and 19A. Among nasal specimens from children with AOM (n\u2009=\u2009319), Spn, Hflu and Mcat were detected in 46%, 43%, and 70%, respectively. The majority (134\/194; 69%) of Spn isolates from the nasal specimens were penicillin- susceptible; frequently observed serotypes were 3,15B, 15C, 23B\/B1, 23A, and 35B. Almost 40% (63\/162) of children colonized with Hflu had a \u03b2-lactamase producing isolate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hflu was most frequently identified in MEF, although the sample size was small. In nasal specimens, antibiotic-resistant Hflu were common, while the majority of Spn were penicillin-susceptible. Continued surveillance could provide valuable data to guide vaccine development and therapeutic decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jpids\/piag059","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:41:18Z","timestamp":1784202078000},"source":"Crossref","is-referenced-by-count":1,"title":["Assessment of Bacterial Pathogens in Young Children with Acute Otitis Media: A Prospective Cohort Study in Western Pennsylvania, 2019-2023"],"prefix":"10.1093","volume":"15","author":[{"given":"Judith M","family":"Martin","sequence":"first","affiliation":[{"name":"School of Medicine, Department of Pediatrics, Division of General Academic Pediatrics, University of Pittsburgh , Pittsburgh, PA 15213 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Hoberman","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatrics, Division of General Academic Pediatrics, University of Pittsburgh , Pittsburgh, PA 15213 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew C","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatrics, Division of General Academic Pediatrics, University of Pittsburgh , Pittsburgh, PA 15213 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin A","family":"Yahner","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatrics, Division of General Academic Pediatrics, University of Pittsburgh , Pittsburgh, PA 15213 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josee","family":"Kahambwe","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatrics, Division of General Academic Pediatrics, University of Pittsburgh , Pittsburgh, PA 15213 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9530-2746","authenticated-orcid":false,"given":"Geizecler","family":"Tomazetto","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatrics, Division of General Academic Pediatrics, University of Pittsburgh , Pittsburgh, PA 15213 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sojin","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatrics, Division of General Academic Pediatrics, University of Pittsburgh , Pittsburgh, PA 15213 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph E","family":"Dohar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, UPMC Children's Hospital of Pittsburgh , 4401 Penn Avenue 7th Floor, Faculty Pavilion, Pittsburgh, PA 15224 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miwako","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, GA 30329 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0808-0231","authenticated-orcid":false,"given":"Kristin","family":"Andrejko","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, GA 30329 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2015-099X","authenticated-orcid":false,"given":"Andrew C","family":"Doxey","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Waterloo , Waterloo, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Briallen","family":"Lobb","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Waterloo , Waterloo, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader","family":"Shaikh","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatrics, Division of General Academic Pediatrics, University of Pittsburgh , Pittsburgh, PA 15213 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"2026080610365049100_ref1","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1001\/jama.2009.1163","article-title":"Antibiotic prescription rates for acute respiratory tract infections in US ambulatory settings","volume":"302","author":"Grijalva","year":"2009","journal-title":"JAMA"},{"key":"2026080610365049100_ref2","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1093\/infdis\/jiaf154","article-title":"Eighteen-year longitudinal study of uncomplicated and complex acute otitis media during the pneumococcal conjugate vaccine era, 2006-2023","volume":"232","author":"Fuji","year":"2025","journal-title":"J Infect Dis"},{"key":"2026080610365049100_ref3","first-page":"1","article-title":"Preventing pneumococcal disease among infants and young children. Recommendations of the advisory committee on immunization practices (ACIP)","volume":"49","author":"Advisory Committee on Immunization Practices","year":"2000","journal-title":"MMWR Recomm Rep"},{"key":"2026080610365049100_ref4","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1093\/infdis\/jiac154","article-title":"Impact of pneumococcal conjugate vaccines on antibiotic-nonsusceptible invasive pneumococcal disease in the United States","volume":"226","author":"Bajema","year":"2022","journal-title":"J Infect Dis"},{"key":"2026080610365049100_ref5","first-page":"CD004977","article-title":"Pneumococcal conjugate vaccines for preventing vaccine-type invasive pneumococcal disease and X-ray defined pneumonia in children less than two years of age","volume":"2009","author":"Lucero","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"2026080610365049100_ref6","doi-asserted-by":"publisher","first-page":"e20190377","DOI":"10.1542\/peds.2019-0377","article-title":"Efficacy and effectiveness of the PCV-10 and PCV-13 vaccines against invasive pneumococcal disease","volume":"145","author":"Berman-Rosa","year":"2020","journal-title":"Pediatrics"},{"key":"2026080610365049100_ref7","doi-asserted-by":"publisher","first-page":"1699","DOI":"10.1093\/cid\/cix115","article-title":"Pneumococcal pneumonia requiring hospitalization in US children in the 13-valent pneumococcal conjugate vaccine era","volume":"64","author":"Olarte","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2026080610365049100_ref8","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1093\/cid\/ciu006","article-title":"Early impact of 13-valent pneumococcal conjugate vaccine on community-acquired pneumonia in children","volume":"58","author":"Angoulvant","year":"2014","journal-title":"Clin Infect Dis"},{"key":"2026080610365049100_ref9","doi-asserted-by":"publisher","first-page":"CD001480","DOI":"10.1002\/14651858.CD001480.pub6","article-title":"Pneumococcal conjugate vaccines for preventing acute otitis media in children","volume":"11","author":"de S\u00e9vaux","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"2026080610365049100_ref10","doi-asserted-by":"publisher","first-page":"e289","DOI":"10.1093\/cid\/ciz1164","article-title":"Dose-specific effectiveness of 7- and 13-valent pneumococcal conjugate vaccines against vaccine-serotype Streptococcus pneumoniae colonization in children","volume":"71","author":"Lewnard","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2026080610365049100_ref11","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1086\/423379","article-title":"Effect of the 7-valent pneumococcal conjugate vaccine on nasopharyngeal colonization by Streptococcus pneumoniae in the first 2 years of life","volume":"39","author":"Ghaffar","year":"2004","journal-title":"Clin Infect Dis"},{"key":"2026080610365049100_ref12","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1097\/INF.0000000000004413","article-title":"Anticipated effects of higher-valency pneumococcal conjugate vaccines on colonization and acute otitis media","volume":"43","author":"Kaur","year":"2024","journal-title":"Pediatr Infect Dis J"},{"key":"2026080610365049100_ref13","doi-asserted-by":"publisher","first-page":"ofy036","DOI":"10.1093\/ofid\/ofy036","article-title":"Changes over time in nasopharyngeal colonization in children under 2 years of age at the time of diagnosis of acute otitis media (1999-2014)","volume":"5","author":"Martin","year":"2018","journal-title":"Open Forum Infect Dis"},{"key":"2026080610365049100_ref14","doi-asserted-by":"publisher","first-page":"1608","DOI":"10.1001\/jama.290.12.1608","article-title":"Effectiveness of inactivated influenza vaccine in preventing acute otitis media in young children: a randomized controlled trial","volume":"290","author":"Hoberman","year":"2003","journal-title":"JAMA."},{"key":"2026080610365049100_ref15","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1177\/0009922810384259","article-title":"Pneumococcal resistance and serotype 19A in Pittsburgh-area children with acute otitis media before and after introduction of 7-valent pneumococcal polysaccharide vaccine","volume":"50","author":"Hoberman","year":"2011","journal-title":"Clin Pediatr (Phila)"},{"key":"2026080610365049100_ref16","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1056\/NEJMoa0912254","article-title":"Treatment of acute otitis media in children under 2 years of age","volume":"364","author":"Hoberman","year":"2011","journal-title":"N Engl J Med"},{"key":"2026080610365049100_ref17","doi-asserted-by":"publisher","first-page":"e286","DOI":"10.1097\/INF.0000000000000445","article-title":"Emergence of Streptococcus pneumoniae serogroups 15 and 35 in nasopharyngeal cultures from young children with acute otitis media","volume":"33","author":"Martin","year":"2014","journal-title":"Pediatr Infect Dis J"},{"key":"2026080610365049100_ref18","doi-asserted-by":"publisher","first-page":"e416","DOI":"10.1097\/INF.0000000000004028","article-title":"Moraxella catarrhalis infrequently cultured from middle ear fluid of children with acute otitis media","volume":"42","author":"Conway","year":"2023","journal-title":"Pediatr Infect Dis J"},{"key":"2026080610365049100_ref19","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1038\/s41390-024-03390-2","article-title":"Modification of an outcome measure to follow symptoms of children with acute otitis media","volume":"97","author":"Shaikh","year":"2025","journal-title":"Pediatr Res"},{"key":"2026080610365049100_ref20","doi-asserted-by":"publisher","first-page":"e275","DOI":"10.1097\/INF.0000000000002027","article-title":"Comparison of bacterial culture results obtained from nasopharyngeal and Midturbinate swabs in children with upper respiratory tract infection symptoms","volume":"37","author":"Martin","year":"2018","journal-title":"Pediatr Infect Dis J"},{"key":"2026080610365049100_ref21","volume-title":"CLSI M100 Performance Standards for Antimicrobial Susceptibility Testing","author":"Clinical and Laboratory Standards Institute (CLSI)","year":"2021","edition":"31"},{"key":"2026080610365049100_ref22","doi-asserted-by":"crossref","first-page":"5551","DOI":"10.1128\/JCM.41.12.5551-5556.2003","article-title":"Quantitative validation of media for transportation and storage of Streptococcus pneumoniae","volume":"41","author":"Charalambous","year":"2003","journal-title":"J Clin Microbiol"},{"key":"2026080610365049100_ref23","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.diagmicrobio.2019.01.007","article-title":"Comparison of FTD\u00ae respiratory pathogens 33 and a singleplex CDC assay for the detection of respiratory viruses: a study from Cameroon","volume":"94","author":"Kenmoe","year":"2019","journal-title":"Diagn Microbiol Infect Dis"},{"key":"2026080610365049100_ref24","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s13073-025-01447-3","article-title":"Metatranscriptomic profiling reveals pathogen and host response signatures of pediatric acute sinusitis and upper respiratory infection","volume":"17","author":"Doxey","year":"2025","journal-title":"Genome Med"},{"key":"2026080610365049100_ref25","doi-asserted-by":"crossref","first-page":"2460","DOI":"10.1128\/JCM.02498-06","article-title":"Evaluation and improvement of real-time PCR assays targeting lytA, ply, and psaA genes for detection of pneumococcal DNA","volume":"45","author":"Carvalho","year":"2007","journal-title":"J Clin Microbiol"},{"key":"2026080610365049100_ref26","doi-asserted-by":"crossref","first-page":"738284","DOI":"10.3389\/fmicb.2021.738284","article-title":"Towards real-time and affordable strain-level metagenomics-based foodborne outbreak investigations using Oxford nanopore sequencing technologies","volume":"12","author":"Buytaers","year":"2021","journal-title":"Front Microbiol"},{"key":"2026080610365049100_ref27","doi-asserted-by":"publisher","DOI":"10.1101\/gr.215087.116","article-title":"Canu: scalable and accurate long-read assembly via adaptive k-mer weighting and repeat separation","volume":"27","author":"Koren","journal-title":"Genome Res"},{"key":"2026080610365049100_ref28","doi-asserted-by":"publisher","volume-title":"Microb Genom","DOI":"10.1099\/mgen.0.000186"},{"key":"2026080610365049100_ref29","doi-asserted-by":"publisher","first-page":"e000357","DOI":"10.1099\/mgen.0.000357","article-title":"Visualizing variation within global pneumococcal sequence clusters (GPSCs) and country population snapshots to contextualize pneumococcal isolates","volume":"6","author":"Gladstone","year":"2020","journal-title":"Microb Genom"},{"key":"2026080610365049100_ref30","doi-asserted-by":"publisher","first-page":"e964","DOI":"10.1542\/peds.2012-3488","article-title":"The diagnosis and management of acute otitis media","volume":"131","author":"Lieberthal","year":"2013","journal-title":"Pediatrics"},{"key":"2026080610365049100_ref31","doi-asserted-by":"publisher","first-page":"fnaf076","DOI":"10.1093\/femsle\/fnaf076","article-title":"Changes in composition of respiratory bacteria colonizing pneumococcal conjugate vaccinated children, 2006-2023","volume":"10","author":"Salamone","year":"2025","journal-title":"FEMS Microbiol Lett"},{"key":"2026080610365049100_ref32","doi-asserted-by":"publisher","first-page":"1627","DOI":"10.3201\/eid2706.204238","article-title":"Twenty-year public health impact of 7- and 13-valent pneumococcal conjugate vaccines in US children","volume":"27","author":"Wasserman","year":"2021","journal-title":"Emerg Infect Dis"},{"key":"2026080610365049100_ref33","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1093\/cid\/ciab066","article-title":"Effectiveness of the 7- and 13-valent pneumococcal conjugate vaccines against vaccine-serotype otitis media","volume":"73","author":"Dagan","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2026080610365049100_ref34","doi-asserted-by":"publisher","first-page":"699","DOI":"10.15585\/mmwr.mm6923e1","article-title":"Impact of the COVID-19 pandemic on emergency department visits-United States, January 1, 2019-May 30, 2020","volume":"69","author":"Hartnett","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026080610365049100_ref35","doi-asserted-by":"publisher","first-page":"e00727","DOI":"10.1128\/IAI.00727-17","article-title":"Pneumococcal phenotype and interaction with nontypeable haemophilus influenzae as determinants of otitis media progression","volume":"86","author":"Lewnard","year":"2018","journal-title":"Infect Immun"},{"key":"2026080610365049100_ref36","doi-asserted-by":"publisher","first-page":"e00225","DOI":"10.1128\/IAI.00225-18","article-title":"Deconstructing pneumococcal progression from colonization to disease","volume":"86","author":"Pelton","year":"2018","journal-title":"Infect Immun"},{"key":"2026080610365049100_ref37","doi-asserted-by":"publisher","first-page":"e609","DOI":"10.1093\/infdis\/jiaf376","article-title":"Pneumococcal serotype distribution and coverage of existing and pipeline pneumococcal vaccines","volume":"232","author":"King","year":"2025","journal-title":"J Infect Dis"},{"key":"2026080610365049100_ref38","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1186\/s13073-024-01406-4","article-title":"Revisiting mutational resistance to ampicillin and cefotaxime in haemophilus influenzae","volume":"16","author":"Diricks","year":"2024","journal-title":"Genome Med"},{"key":"2026080610365049100_ref39","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.15585\/mmwr.mm7137a3","article-title":"Use of 15-valent pneumococcal conjugate vaccine among U.S. children: updated recommendations of the advisory committee on immunization practices \u2014 United States, 2022","volume":"71","author":"Kobayashi","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026080610365049100_ref40","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.15585\/mmwr.mm7239a5","article-title":"Recommendations for use of 20-valent pneumococcal conjugate vaccine in children - United States, 2023","volume":"72","author":"Updates","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026080610365049100_ref41","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/S1473-3099(23)00572-8","article-title":"Evaluating the safety, tolerability, and immunogenicity of a 24-valent pneumococcal conjugate vaccine (VAX-24) in healthy adults aged 18 to 64 years: a phase 1\/2, double-masked, dose-finding, active-controlled, randomised clinical trial","volume":"24","author":"Wassil","year":"2024","journal-title":"Lancet Infect Dis"},{"key":"2026080610365049100_ref42","doi-asserted-by":"publisher","first-page":"ofae220","DOI":"10.1093\/ofid\/ofae220","article-title":"Immunogenicity of current and next-generation pneumococcal conjugate vaccines in children: current challenges and upcoming opportunities","volume":"11","author":"Feemster","year":"2024","journal-title":"Open Forum Infect Dis"},{"key":"2026080610365049100_ref43","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1016\/S1473-3099(24)00588-7","article-title":"PSERENADE team. Serotype distribution of remaining invasive pneumococcal disease after extensive use of ten-valent and 13-valent pneumococcal conjugate vaccines (the PSERENADE project): a global surveillance analysis","volume":"25","author":"Garcia Quesada","year":"2025","journal-title":"Lancet Infect Dis"},{"key":"2026080610365049100_ref44","article-title":"Active bacterial Core surveillance (ABCs): Bact facts interactive data dashboard. Centers for Disease Control and Prevention","author":"CDC","year":"2024","journal-title":"Updated"},{"key":"2026080610365049100_ref45","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1097\/INF.0000000000004334","article-title":"A phase three study of the safety and immunogenicity of a four-dose series of 20-valent pneumococcal conjugate vaccine in healthy infants","volume":"43","author":"Senders","year":"2024","journal-title":"Pediatr Infect Dis J"},{"key":"2026080610365049100_ref46","doi-asserted-by":"publisher","first-page":"e184","DOI":"10.1097\/INF.0000000000004686","article-title":"Similarities and differences between countries when estimating the effect of higher-valency pneumococcal conjugate vaccines on colonization and acute otitis media","volume":"44","author":"Levy","year":"2025","journal-title":"Pediatr Infect Dis J"},{"key":"2026080610365049100_ref47","doi-asserted-by":"publisher","first-page":"664083","DOI":"10.3389\/fped.2021.664083","article-title":"Streptococcus pneumoniae serotypes carried by young children and their association with acute otitis media during the period 2016-2019","volume":"5","author":"Ekinci","year":"2021","journal-title":"Front Pediatr"}],"container-title":["Journal of the Pediatric Infectious Diseases Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jpids\/advance-article-pdf\/doi\/10.1093\/jpids\/piag059\/69163177\/piag059.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jpids\/article-pdf\/15\/8\/piag059\/69163177\/piag059.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jpids\/article-pdf\/15\/8\/piag059\/69163177\/piag059.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T14:36:58Z","timestamp":1786027018000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jpids\/article\/doi\/10.1093\/jpids\/piag059\/8736524"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,17]]},"references-count":47,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8,4]]}},"URL":"https:\/\/doi.org\/10.1093\/jpids\/piag059","relation":{},"ISSN":["2048-7207"],"issn-type":[{"value":"2048-7207","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8]]},"published":{"date-parts":[[2026,7,17]]},"article-number":"piag059"}}