{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T03:45:48Z","timestamp":1792122348769,"version":"4.4.0"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,12,21]],"date-time":"2018-12-21T00:00:00Z","timestamp":1545350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study examined the impact of the routine pneumococcal conjugate vaccination (PCV) on childhood community\u2010acquired bacteraemia (CAB) and antibiotic resistance patterns in Israeli children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Israel added the PCV vaccine to its national immunisation programme in July 2009. We retrospectively analysed the medical records of all patients with CAB under 18\u00a0years at three children's hospitals in Tel Aviv and Jerusalem from 2007 to 2015. The microbiological data, clinical presentation, pneumococcal serotype distribution, antibiotic susceptibility and outcomes of infections were compared before and after the vaccine was introduced.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 511\u00a0904 emergency department visits and 125\u00a0922 children were hospitalised. Of those, 238 had CAB before vaccination was introduced (mean age 17\u00a0months) and 316 had CAB after the introduction (mean age 21\u00a0months). Emergency department presentations for CAB fell from 141.8 to 91.8 per 100\u00a0000 visits: a relative risk reduction (RRR) of 35%. Hospitalisations for CAB decreased from 430 to 337 per 100\u00a0000 admissions: an RRR of 22%. Hospitalisations due to\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      increased significantly and penicillin nonsusceptible blood\n                      <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      isolates decreased significantly.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Introducing national pneumococcal conjugate vaccination significantly changed the epidemiology of CAB, with reduced antibiotic\u2010resistant\n                      <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      and increased hospitalisation rates for\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      infections.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.14670","type":"journal-article","created":{"date-parts":[[2018,12,2]],"date-time":"2018-12-02T08:43:34Z","timestamp":1543740214000},"page":"1321-1328","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Paediatric community\u2010acquired bacteraemia, pneumococcal invasive disease and antibiotic resistance fell after the pneumococcal conjugate vaccine was introduced"],"prefix":"10.1111","volume":"108","author":[{"given":"Yael","family":"Berger","sequence":"first","affiliation":[{"name":"Hadassah Hebrew University Medical Centre Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2957-9741","authenticated-orcid":false,"given":"Amos","family":"Adler","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory Tel Aviv Sourasky Medical Centre Tel Aviv Israel"},{"name":"The Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tenenbaum","family":"Ariel","sequence":"additional","affiliation":[{"name":"Pediatric Department MS Pediatric Division Hadassah Hebrew University Medical Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assaf","family":"Rokney","sequence":"additional","affiliation":[{"name":"Government Central Laboratories Ministry of Health Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Averbuch","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Pediatric Division Hadassah Hebrew University Medical Centre Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9242-9423","authenticated-orcid":false,"given":"Galia","family":"Grisaru\u2010Soen","sequence":"additional","affiliation":[{"name":"The Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"Pediatric Infectious Disease Unit of Dana Children's Hospital Tel Aviv Sourasky Medical Centre Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13052-015-0189-4"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c1594"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0104197"},{"key":"e_1_2_11_5_1","first-page":"253","article-title":"Invasive pneumococcal disease in young children before licensure of 13\u2010valent pneumococcal conjugate vaccine \u2014 United States, 2007","volume":"59","author":"Centers for Disease Control and Prevention","year":"2010","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31012-1"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000002100"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000000604"},{"key":"e_1_2_11_9_1","volume-title":"Performance standards for antimicrobial susceptibility testing: 18th informational supplement. 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