{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:20:19Z","timestamp":1788240019017,"version":"build-2803163510"},"reference-count":25,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>We hypothesized that the incidence, clinical presentation, isolate serotypes, and isolate antibiotic susceptibility of Streptococcus pneumoniae causing pneumonia in children varied before and through the course of the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients aged 18\u00a0years or younger at 8 children\u2019s hospitals in the United States admitted with culture-positive pneumonia were identified. Serotyping of pneumococcal isolates was performed at a central research laboratory. Clinical and laboratory data were collected retrospectively with a standardized case report form.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>We identified 190 patients with pneumococcal pneumonia from 2017 to 2023. Cases decreased significantly in 2020 (P\u2009&amp;lt;\u2009.05), with a surge in 2022 and 2023. Serotype 3 was the most common serotype, was prominent after 2021, and was associated with a significantly higher rate of empyema and necrotizing parenchyma (P\u2009&amp;lt;\u2009.001). PCV13 serotypes 3, 19A, and 19F constituted over half of isolates; new serotypes in PCV15 (22F and 33F) and PCV20 (8, 10A, 11A, 12F, 15B, 22F, and 33F) accounted for 14% and 23% of isolates, respectively. Penicillin susceptibility (minimum inhibitory concentration [MIC]\u2009\u2264\u20092\u00a0\u03bcg\/mL) was very common (94% of isolates), and all 11 isolates with MIC greater than 2\u00a0\u03bcg\/mL were serotype 19A. Of those tested, 90 patients had viral coinfections; only influenza was associated with more pneumonia complications compared with patients without influenza (P\u2009=\u2009.002).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>S pneumoniae remains an important cause of pneumonia in children with the potential for severe infections. After 2020, increasing rates have primarily been due to serotype 3, while \u03b2-lactam resistance was largely associated with serotype 19A. PCV15 and PCV20 may modestly reduce pneumococcal pneumonia incidence further.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2025-073196","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:02:07Z","timestamp":1777248127000},"source":"Crossref","is-referenced-by-count":2,"title":["Pneumococcal Pneumonia in Hospitalized Children: 2017\u20132023"],"prefix":"10.1542","volume":"157","author":[{"given":"Eric E.","family":"Engstrom","sequence":"first","affiliation":[{"name":"1Texas Children\u2019s Hospital and Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheldon L.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"1Texas Children\u2019s Hospital and Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Barson","sequence":"additional","affiliation":[{"name":"2Nationwide Children\u2019s Hospital and the Ohio State University College of Medicine and Public Health, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philana Ling","family":"Lin","sequence":"additional","affiliation":[{"name":"3Children\u2019s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Dahl","sequence":"additional","affiliation":[{"name":"4Arkansas Children\u2019s Hospital and the University of Arkansas for Medical Sciences, Little Rock, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Bradley","sequence":"additional","affiliation":[{"name":"5Rady Children\u2019s Hospital San Diego and the University of California, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia S.","family":"Pannaraj","sequence":"additional","affiliation":[{"name":"5Rady Children\u2019s Hospital San Diego and the University of California, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina Q.","family":"Tan","sequence":"additional","affiliation":[{"name":"6Ann & Robert H. Lurie Children\u2019s Hospital of Chicago and the Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Dien Bard","sequence":"additional","affiliation":[{"name":"7Children\u2019s Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kacy","family":"Ramirez","sequence":"additional","affiliation":[{"name":"8Brenner Children\u2019s Hospital and the Wake Forest School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay R.","family":"Grant","sequence":"additional","affiliation":[{"name":"9Pfizer, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriano","family":"Arguedas","sequence":"additional","affiliation":[{"name":"9Pfizer, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria J.","family":"Tort","sequence":"additional","affiliation":[{"name":"9Pfizer, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Miller","sequence":"additional","affiliation":[{"name":"9Pfizer, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Can\u00e9","sequence":"additional","affiliation":[{"name":"9Pfizer, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina G.","family":"Hulten","sequence":"additional","affiliation":[{"name":"1Texas Children\u2019s Hospital and Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"issue":"12","key":"2026090101064497600_r1","doi-asserted-by":"crossref","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":"2026090101064497600_r2","doi-asserted-by":"crossref","first-page":"05002","DOI":"10.7189\/jogh.13.05002","article-title":"Systematic review on the impact of the pneumococcal conjugate vaccine ten valent (PCV10) or thirteen valent (PCV13) on all-cause, radiologically confirmed and severe pneumonia hospitalisation rates and pneumonia mortality in children 0\u20139\u00a0years old","volume":"13","author":"Reyburn","year":"2023","journal-title":"J Glob Health."},{"issue":"1","key":"2026090101064497600_r3","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1097\/INF.0000000000003748","article-title":"Invasive pneumococcal disease in high-risk children: a 10-year retrospective study","volume":"42","author":"van Warmerdam","year":"2023","journal-title":"Pediatr Infect Dis J."},{"issue":"12","key":"2026090101064497600_r4","doi-asserted-by":"crossref","first-page":"e70062","DOI":"10.1002\/iid3.70062","article-title":"Serotype 3 Streptococcus pneumoniae escapes the immune responses induced by PCV13 in mice with high susceptibility to infection","volume":"12","author":"Oliveira","year":"2024","journal-title":"Immun Inflamm Dis."},{"issue":"10","key":"2026090101064497600_r5","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.3201\/eid2910.230519","article-title":"Serotype distribution and disease severity in adults hospitalized with Streptococcus pneumoniae infection, Bristol and Bath, UK, 2006\u20132022","volume":"29","author":"Hyams","year":"2023","journal-title":"Emerg Infect Dis."},{"issue":"3","key":"2026090101064497600_r6","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/S1473-3099(20)30489-8","article-title":"The direct effect of pneumococcal conjugate vaccines on invasive pneumococcal disease in children in the Latin American and Caribbean region (SIREVA 2006\u201317): a multicentre, retrospective observational study","volume":"21","author":"Agudelo","year":"2021","journal-title":"Lancet Infect Dis."},{"issue":"11","key":"2026090101064497600_r7","doi-asserted-by":"crossref","first-page":"ofad563","DOI":"10.1093\/ofid\/ofad563","article-title":"Invasive community-onset gram-positive infections from July 2018 through December 2022 at 2 children\u2019s hospitals","volume":"10","author":"Engstrom","year":"2023","journal-title":"Open Forum Infect Dis."},{"issue":"11","key":"2026090101064497600_r8","doi-asserted-by":"crossref","first-page":"2321","DOI":"10.3201\/eid2811.211741","article-title":"Effect of COVID-19 pandemic on invasive pneumococcal disease in children, Catalonia, Spain","volume":"28","author":"Ciruela","year":"2022","journal-title":"Emerg Infect Dis."},{"issue":"4","key":"2026090101064497600_r9","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1093\/cid\/ciad746","article-title":"Age-specific resurgence in invasive pneumococcal disease incidence in the COVID-19 pandemic era and its association with respiratory virus and pneumococcal carriage dynamics: a time-series analysis","volume":"78","author":"Rybak","year":"2024","journal-title":"Clin Infect Dis."},{"issue":"1","key":"2026090101064497600_r10","doi-asserted-by":"crossref","first-page":"e2023063039","DOI":"10.1542\/peds.2023-063039","article-title":"Invasive pneumococcal disease after 2 decades of pneumococcal conjugate vaccine use","volume":"153","author":"Yildirim","year":"2024","journal-title":"Pediatrics."},{"issue":"5","key":"2026090101064497600_r11","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/S1473-3099(23)00706-5","article-title":"Invasive pneumococcal disease 3\u00a0years after introduction of a reduced 1\u2009+\u20091 infant 13-valent pneumococcal conjugate vaccine immunisation schedule in England: a prospective national observational surveillance study","volume":"24","author":"Bertran","year":"2024","journal-title":"Lancet Infect Dis."},{"issue":"RR-11","key":"2026090101064497600_r12","first-page":"1","article-title":"Prevention of pneumococcal disease among infants and children - use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine - recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"59","author":"Nuorti","year":"2010","journal-title":"MMWR Recomm Rep."},{"key":"2026090101064497600_r13","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing","author":"Mathers","year":"2024","edition":"34th ed"},{"key":"2026090101064497600_r14","article-title":"Centers for Disease Control and Prevention","author":"Pneumococcal disease surveillance and trends","year":"2026"},{"issue":"12","key":"2026090101064497600_r15","doi-asserted-by":"crossref","first-page":"2135","DOI":"10.1093\/cid\/ciy920","article-title":"Effectiveness of 13-valent pneumococcal conjugate vaccine against invasive disease caused by serotype 3 in children: a systematic review and meta-analysis of observational studies","volume":"68","author":"Sings","year":"2019","journal-title":"Clin Infect Dis."},{"key":"2026090101064497600_r16","doi-asserted-by":"crossref","first-page":"128128","DOI":"10.1016\/j.vaccine.2025.128128","article-title":"Serotype distribution and antimicrobial resistance in pediatric invasive pneumococcal pneumonia: a laboratory surveillance study from Argentina, 2022\u20132024","volume":"72","author":"Zintgraff","year":"2026","journal-title":"Vaccine."},{"key":"2026090101064497600_r17","doi-asserted-by":"crossref","first-page":"613287","DOI":"10.3389\/fcimb.2020.613287","article-title":"Sugar-coated killer: serotype 3 pneumococcal disease","volume":"10","author":"Luck","year":"2020","journal-title":"Front Cell Infect Microbiol."},{"issue":"9","key":"2026090101064497600_r18","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1056\/NEJMoa1405870","article-title":"Community-acquired pneumonia requiring hospitalization among U.S. children","volume":"372","author":"Jain","year":"2015","journal-title":"N Engl J Med."},{"issue":"1","key":"2026090101064497600_r19","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1093\/tropej\/44.1.18","article-title":"The importance of clinical symptoms and signs in the diagnosis of community-acquired pneumonia","volume":"44","author":"Pereira","year":"1998","journal-title":"J Trop Pediatr."},{"key":"2026090101064497600_r20","doi-asserted-by":"crossref","first-page":"83","DOI":"10.2147\/PHMT.S120156","article-title":"Managing acute abdominal pain in pediatric patients: current perspectives","volume":"8","author":"Hijaz","year":"2017","journal-title":"Pediatric Health Med Ther."},{"issue":"6","key":"2026090101064497600_r21","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1093\/cid\/ciae439","article-title":"Clinical impact of pleural fluid Streptococcus pneumoniae polymerase chain reaction testing in children with complicated pneumonia","volume":"79","author":"Ho","year":"2024","journal-title":"Clin Infect Dis."},{"issue":"Suppl 3","key":"2026090101064497600_r22","doi-asserted-by":"crossref","first-page":"S209","DOI":"10.1093\/infdis\/jiab073","article-title":"Comparison of culture, antigen test, and polymerase chain reaction for pneumococcal detection in cerebrospinal fluid of children","volume":"224","author":"Hasanuzzaman","year":"2021","journal-title":"J Infect Dis."},{"key":"2026090101064497600_r23","volume-title":"PCR detection of Streptococcus pneumoniae is a necessary tool to identify pneumococcal pneumonia\/empyema","author":"Kristina","year":"2024"},{"issue":"7","key":"2026090101064497600_r24","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.1093\/cid\/cir531","article-title":"The management of community-acquired pneumonia in infants and children older than 3\u00a0months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America","volume":"53","author":"Bradley","year":"2011","journal-title":"Clin Infect Dis."},{"issue":"39","key":"2026090101064497600_r25","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.15585\/mmwr.mm7239a5","article-title":"ACIP updates: recommendations for use of 20-valent pneumococcal conjugate vaccine in children - United States, 2023","volume":"72","author":"Centers for Disease Control and Prevention (CDC)","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-073196\/1927405\/pediatrics.2025073196.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-073196\/1927405\/pediatrics.2025073196.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:06:50Z","timestamp":1788239210000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/157\/5\/e2025073196\/207236\/Pneumococcal-Pneumonia-in-Hospitalized-Children"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,27]]},"references-count":25,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,4,27]]},"published-print":{"date-parts":[[2026,5,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2025-073196","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,27]]},"article-number":"e2025073196"}}