{"id":"https://openalex.org/W7125957080","doi":"https://doi.org/10.6084/m9.figshare.31169491","title":"The impact of pneumococcal conjugate vaccines on disease epidemiology, serotype distribution, and antimicrobial resistance in children. A 25-year observational study in Athens, Greece (1996\u20132021)","display_name":"The impact of pneumococcal conjugate vaccines on disease epidemiology, serotype distribution, and antimicrobial resistance in children. A 25-year observational study in Athens, Greece (1996\u20132021)","publication_year":2026,"publication_date":"2026-01-01","ids":{"openalex":"https://openalex.org/W7125957080","doi":"https://doi.org/10.6084/m9.figshare.31169491"},"language":"en","primary_location":{"id":"doi:10.6084/m9.figshare.31169491","doi":"https://doi.org/10.6084/m9.figshare.31169491","is_oa":true,"landing_page_url":"https://doi.org/10.6084/m9.figshare.31169491","pdf_url":null,"source":{"id":"https://openalex.org/S4377196282","display_name":"Figshare","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I4210132348","host_organization_name":"Figshare (United Kingdom)","host_organization_lineage":["https://openalex.org/I4210132348"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"JournalArticle"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["datacite"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.6084/m9.figshare.31169491","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5088027451","display_name":"Vasiliki Syriopoulou","orcid":"https://orcid.org/0000-0003-0592-9591","observed_orcids":["https://orcid.org/0000-0003-0592-9591"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Syriopoulou, Vasiliki P.","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5038285556","display_name":"George L. Daikos","orcid":"https://orcid.org/0000-0001-5365-4874","observed_orcids":["https://orcid.org/0000-0001-5365-4874"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Daikos, George L.","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5033294033","display_name":"Emmanouil I. Koutouzis","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Koutouzis, Emmanouil I.","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5002370072","display_name":"Elizabeth\u2010Barbara Tatsi","orcid":"https://orcid.org/0000-0001-7325-6195","observed_orcids":["https://orcid.org/0000-0001-7325-6195"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Tatsi, Elizabeth-Barbara","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5032745277","display_name":"Theano Georgakopoulou","orcid":"https://orcid.org/0000-0001-9559-7476","observed_orcids":["https://orcid.org/0000-0001-9559-7476"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Georgakopoulou, Theano","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5027983710","display_name":"Foteini I. Koutouzi","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Koutouzi, Foteini I.","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5111858253","display_name":"Ageliki Stathi","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Stathi, Ageliki","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5027174994","display_name":"Kalliopi Spyridopoulou","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Spyridopoulou, Kalliopi","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5029369153","display_name":"Anthi Sideri","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Sideri, Anthi","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5124053858","display_name":"Anastasios Doudoulakakis","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Doudoulakakis, Anastasios","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5076520237","display_name":"Georgios Kalogeras","orcid":"https://orcid.org/0000-0001-9831-4291","observed_orcids":["https://orcid.org/0000-0001-9831-4291"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Kalogeras, Georgios","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5042272515","display_name":"Theodota Liakopoulou","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Liakopoulou, Theodota","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5032274587","display_name":"Dimitra\u2010Maria Koukou","orcid":"https://orcid.org/0000-0002-2923-3153","observed_orcids":["https://orcid.org/0000-0002-2923-3153"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Koukou, Dimitra-Maria","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5124136016","display_name":"Chara Asimaki","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Asimaki, Chara","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5093097351","display_name":"Eleni Tsapra","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Tsapra, Eleni","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5112616094","display_name":"Evangelia Lebessi","orcid":"https://orcid.org/0000-0002-2069-9416","observed_orcids":["https://orcid.org/0000-0002-2069-9416"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Lebessi, Evangelia","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5077295921","display_name":"Levantia Zachariadou","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Zachariadou, Levantia","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5071781706","display_name":"Eleni Papadogeorgaki","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Papadogeorgaki, Eleni","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5017896785","display_name":"Athanasios G. Michos","orcid":"https://orcid.org/0000-0003-1745-1118","observed_orcids":["https://orcid.org/0000-0003-1745-1118"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Michos, Athanasios","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10654","display_name":"Pneumonia and Respiratory Infections","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10654","display_name":"Pneumonia and Respiratory Infections","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10873","display_name":"Bacterial Infections and Vaccines","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2404","display_name":"Microbiology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T11688","display_name":"Microbial infections and disease research","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2404","display_name":"Microbiology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/pneumococcal-conjugate-vaccine","display_name":"pneumococcal conjugate vaccine","score":0.9259999990463257},{"id":"https://openalex.org/keywords/pcv7","display_name":"PCV7","score":0.7639999985694885},{"id":"https://openalex.org/keywords/pcv13","display_name":"PCV13","score":1.0},{"id":"https://openalex.org/keywords/streptococcus-pneumoniae","display_name":"Streptococcus pneumoniae","score":0.9940000176429749},{"id":"https://openalex.org/keywords/invasive-pneumococcal-disease","display_name":"invasive pneumococcal disease","score":0.9959999918937683},{"id":"https://openalex.org/keywords/serotype-distribution","display_name":"serotype distribution","score":0.9399999976158142},{"id":"https://openalex.org/keywords/serotype-replacement","display_name":"serotype replacement","score":0.703000009059906},{"id":"https://openalex.org/keywords/serotype-3","display_name":"serotype 3","score":0.7699999809265137},{"id":"https://openalex.org/keywords/serotype-19a","display_name":"serotype 19A","score":0.8679999709129333},{"id":"https://openalex.org/keywords/serotype-19f","display_name":"serotype 19F","score":0.9570000171661377},{"id":"https://openalex.org/keywords/serotype-23f","display_name":"serotype 23F","score":0.9210000038146973},{"id":"https://openalex.org/keywords/antimicrobial-resistance","display_name":"antimicrobial resistance","score":0.8389999866485596},{"id":"https://openalex.org/keywords/multidrug-resistance","display_name":"multidrug resistance","score":0.9779999852180481},{"id":"https://openalex.org/keywords/vaccine-failure","display_name":"vaccine failure","score":0.8579999804496765},{"id":"https://openalex.org/keywords/empyema","display_name":"empyema","score":0.8489999771118164},{"id":"https://openalex.org/keywords/children","display_name":"children","score":0.5490000247955322},{"id":"https://openalex.org/keywords/athens-greece","display_name":"Athens, Greece","score":0.9190000295639038},{"id":"https://openalex.org/keywords/vaccine-impact","display_name":"vaccine impact","score":0.4480000138282776},{"id":"https://openalex.org/keywords/serotype-surveillance","display_name":"serotype surveillance","score":0.4259999990463257}],"concepts":[{"id":"https://openalex.org/C10389963","wikidata":"https://www.wikidata.org/wiki/Q848328","display_name":"Serotype","level":2,"score":0.8240000009536743},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7894999980926514},{"id":"https://openalex.org/C2781253189","wikidata":"https://www.wikidata.org/wiki/Q221179","display_name":"Streptococcus pneumoniae","level":3,"score":0.5029000043869019},{"id":"https://openalex.org/C2778866548","wikidata":"https://www.wikidata.org/wiki/Q7205991","display_name":"Pneumococcal conjugate vaccine","level":4,"score":0.49070000648498535},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.47859999537467957},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.478300005197525},{"id":"https://openalex.org/C94665300","wikidata":"https://www.wikidata.org/wiki/Q63391344","display_name":"Antibiotic resistance","level":3,"score":0.47440001368522644},{"id":"https://openalex.org/C2776152631","wikidata":"https://www.wikidata.org/wiki/Q4366062","display_name":"Pneumococcal infections","level":4,"score":0.4562000036239624},{"id":"https://openalex.org/C4937899","wikidata":"https://www.wikidata.org/wiki/Q68541106","display_name":"Antimicrobial","level":2,"score":0.43070000410079956},{"id":"https://openalex.org/C3020803494","wikidata":"https://www.wikidata.org/wiki/Q2712836","display_name":"Pneumococcal disease","level":4,"score":0.42800000309944153},{"id":"https://openalex.org/C159047783","wikidata":"https://www.wikidata.org/wiki/Q7215","display_name":"Virology","level":1,"score":0.41760000586509705},{"id":"https://openalex.org/C32762888","wikidata":"https://www.wikidata.org/wiki/Q235356","display_name":"Carriage","level":2,"score":0.40959998965263367},{"id":"https://openalex.org/C23131810","wikidata":"https://www.wikidata.org/wiki/Q818574","display_name":"Observational study","level":2,"score":0.3961000144481659},{"id":"https://openalex.org/C2781209916","wikidata":"https://www.wikidata.org/wiki/Q3215756","display_name":"Typing","level":2,"score":0.3849000036716461},{"id":"https://openalex.org/C2779583294","wikidata":"https://www.wikidata.org/wiki/Q5161160","display_name":"Conjugate vaccine","level":4,"score":0.37880000472068787},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.3727000057697296},{"id":"https://openalex.org/C2777288759","wikidata":"https://www.wikidata.org/wiki/Q4164182","display_name":"Dosing","level":2,"score":0.3686000108718872},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.3517000079154968},{"id":"https://openalex.org/C22070199","wikidata":"https://www.wikidata.org/wiki/Q192995","display_name":"Vaccination","level":2,"score":0.3463999927043915},{"id":"https://openalex.org/C2780664029","wikidata":"https://www.wikidata.org/wiki/Q5282120","display_name":"Disease burden","level":3,"score":0.33000001311302185},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.32510000467300415},{"id":"https://openalex.org/C89423630","wikidata":"https://www.wikidata.org/wiki/Q7193","display_name":"Microbiology","level":1,"score":0.31029999256134033},{"id":"https://openalex.org/C2779301066","wikidata":"https://www.wikidata.org/wiki/Q14538008","display_name":"Pneumococcal vaccine","level":4,"score":0.2987000048160553},{"id":"https://openalex.org/C501593827","wikidata":"https://www.wikidata.org/wiki/Q12187","display_name":"Antibiotics","level":2,"score":0.2955000102519989},{"id":"https://openalex.org/C3020448403","wikidata":"https://www.wikidata.org/wiki/Q5282120","display_name":"Burden of disease","level":3,"score":0.2897999882698059},{"id":"https://openalex.org/C133936738","wikidata":"https://www.wikidata.org/wiki/Q643839","display_name":"Multiple drug resistance","level":3,"score":0.28060001134872437},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.2676999866962433},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.2669000029563904},{"id":"https://openalex.org/C114851261","wikidata":"https://www.wikidata.org/wiki/Q12147416","display_name":"Drug resistance","level":2,"score":0.25440001487731934},{"id":"https://openalex.org/C143701427","wikidata":"https://www.wikidata.org/wiki/Q193566","display_name":"Incubation period","level":3,"score":0.250900000333786}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.6084/m9.figshare.31169491","doi":"https://doi.org/10.6084/m9.figshare.31169491","is_oa":true,"landing_page_url":"https://doi.org/10.6084/m9.figshare.31169491","pdf_url":null,"source":{"id":"https://openalex.org/S4377196282","display_name":"Figshare","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I4210132348","host_organization_name":"Figshare (United Kingdom)","host_organization_lineage":["https://openalex.org/I4210132348"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"JournalArticle"},{"id":"doi:10.6084/m9.figshare.31169491.v1","doi":"https://doi.org/10.6084/m9.figshare.31169491.v1","is_oa":true,"landing_page_url":"https://doi.org/10.6084/m9.figshare.31169491.v1","pdf_url":null,"source":{"id":"https://openalex.org/S4377196282","display_name":"Figshare","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I4210132348","host_organization_name":"Figshare (United Kingdom)","host_organization_lineage":["https://openalex.org/I4210132348"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"JournalArticle"}],"best_oa_location":{"id":"doi:10.6084/m9.figshare.31169491","doi":"https://doi.org/10.6084/m9.figshare.31169491","is_oa":true,"landing_page_url":"https://doi.org/10.6084/m9.figshare.31169491","pdf_url":null,"source":{"id":"https://openalex.org/S4377196282","display_name":"Figshare","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I4210132348","host_organization_name":"Figshare (United Kingdom)","host_organization_lineage":["https://openalex.org/I4210132348"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"JournalArticle"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2998369475","https://openalex.org/W2339199544","https://openalex.org/W2735385734","https://openalex.org/W4386325488","https://openalex.org/W4379768113","https://openalex.org/W7151392396","https://openalex.org/W7155038741","https://openalex.org/W2296086209","https://openalex.org/W4295129587","https://openalex.org/W2893022970"],"abstract_inverted_index":{"Streptococcus":[0],"pneumoniae":[1],"continues":[2],"to":[3,148,178,189,204],"cause":[4],"invasive":[5],"pneumococcal":[6,16,30],"disease":[7,31,138],"(IPD)":[8],"and":[9,27,35,69,74,121,130,193,216,221,245,255],"non-IPD":[10],"in":[11,38,42,51,61,123,144,150,167,202,206,229,241],"children,":[12],"despite":[13],"widely":[14],"implemented":[15],"conjugate":[17],"vaccines":[18],"(PCVs).":[19],"This":[20],"study":[21,50],"evaluated":[22],"the":[23,88,124,145,168,224,230,236,242,247],"impact":[24],"of":[25,57,114,185,239],"PCV7":[26],"PCV13":[28],"on":[29],"(PD),":[32],"serotype":[33,172],"distribution,":[34],"antimicrobial":[36],"resistance":[37,196,256],"children":[39,80,116,158],"\u226414":[40],"years":[41],"Athens,":[43],"Greece.":[44],"We":[45],"conducted":[46],"a":[47],"retrospective":[48],"multicenter":[49],"five":[52],"pediatric":[53,59],"hospitals":[54],"covering":[55],"~80%":[56],"Athens\u2019":[58],"population":[60],"three":[62],"time":[63,220],"periods;":[64],"pre-PCV":[65,146,203],"(1996\u20132005),":[66],"post-PCV7":[67],"(2006\u20132010),":[68],"post-PCV13":[70,207,231],"(2011\u20132021).":[71],"Clinical,":[72],"microbiological,":[73],"demographic":[75],"data":[76],"were":[77,96,108,119,183],"collected":[78],"for":[79,250],"with":[81,117,128,133,212],"PD.":[82],"Capsular":[83],"typing":[84],"was":[85],"performed":[86],"by":[87,98,110],"Quellung":[89],"reaction.":[90],"Untypeable":[91],"or":[92],"antiserum":[93],"cross-reacting":[94],"isolates":[95],"typed":[97],"Next":[99],"Generation":[100],"Sequencing":[101],"(NGS).":[102],"The":[103],"minimal":[104],"inhibitory":[105],"concentrations":[106],"(MICs)":[107],"determined":[109],"Etest.":[111],"A":[112],"total":[113],"2546":[115],"PD":[118,240],"identified":[120],"included":[122],"analysis;":[125],"1233":[126],"(48.4%)":[127],"IPD":[129,140],"1313":[131],"(51.6%)":[132],"non-IPD.":[134],"PCVs":[135],"significantly":[136,166],"impacted":[137],"patterns:":[139],"declined":[141],"from":[142,200],"59%":[143],"period":[147,208],"35.1%":[149],"post-PCV13,":[151],"while":[152],"age":[153],"distribution":[154],"shifted":[155],"toward":[156],"older":[157],"(p":[159,209],"<":[160,210],".001).":[161],"All":[162],"PCV7/13":[163],"serotypes":[164,190,214],"decreased":[165],"post-PCV":[169,243],"periods,":[170],"except":[171],"3":[173],"which":[174],"increased,":[175],"contributing":[176],"substantially":[177],"empyema":[179],"cases.":[180],"Vaccine":[181],"failures":[182],"9.8%":[184],"cases,":[186],"mostly":[187],"attributed":[188],"3,":[191],"19A,":[192],"19F.":[194],"Multidrug":[195],"(MDR)":[197],"rates":[198],"rose":[199],"12.9%":[201],"24.8%":[205],".001),":[211],"MDR":[213,226],"19F":[215],"23F":[217],"decreasing":[218],"over":[219],"19A":[222],"becoming":[223],"predominant":[225],"phenotype":[227],"(47.1%)":[228],"era.":[232],"These":[233],"findings":[234],"underscore":[235],"dynamic":[237],"nature":[238],"era":[244],"highlight":[246],"ongoing":[248],"need":[249],"surveillance":[251],"studies,":[252],"vaccine":[253],"updates":[254],"monitoring.":[257]},"counts_by_year":[],"updated_date":"2026-10-28T10:33:24.094632","created_date":"2026-01-29T00:00:00"}