{"entity": "researcher", "timestamp": "2026-08-28T00:26:23.453Z", "family": "Ryd-Rinder", "given": "Malin", "initials": "M", "orcid": "0000-0002-2947-4117", "affiliations": ["Pediatric Emergency Department, Astrid Lindgren Children's Hospital, Karolinska University Hospital, S-171 64 Solna, Sweden.", "Department of Women's and Children's Health, Karolinska Institutet, S-171 77 Stockholm, Sweden."], "links": {"self": {"href": "https://publications-affiliated.scilifelab.se/researcher/26d0bc6c51624cf3880b6ec8dbf38e71.json"}, "display": {"href": "https://publications-affiliated.scilifelab.se/researcher/26d0bc6c51624cf3880b6ec8dbf38e71"}}, "publications": [{"entity": "publication", "iuid": "8fa8cde55e9c40d78a3cb227bf1331c4", "links": {"self": {"href": "https://publications-affiliated.scilifelab.se/publication/8fa8cde55e9c40d78a3cb227bf1331c4.json"}, "display": {"href": "https://publications-affiliated.scilifelab.se/publication/8fa8cde55e9c40d78a3cb227bf1331c4"}}, "title": "Etiology of Clinical Community-Acquired Pneumonia in Swedish Children Aged 1-59 Months with High Pneumococcal Vaccine Coverage-The TREND Study.", "authors": [{"family": "Eklundh", "given": "Annika", "initials": "A", "orcid": "0000-0003-0482-4851", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/80098722901d4e808ab8be86c95ac3f4.json"}}, {"family": "Rhedin", "given": "Samuel", "initials": "S", "orcid": "0000-0001-5798-2875", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/c42b5a39f1444f699385316533eba745.json"}}, {"family": "Ryd-Rinder", "given": "Malin", "initials": "M", "orcid": "0000-0002-2947-4117", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/26d0bc6c51624cf3880b6ec8dbf38e71.json"}}, {"family": "Andersson", "given": "Maria", "initials": "M"}, {"family": "Gantelius", "given": "Jesper", "initials": "J"}, {"family": "Gaudenzi", "given": "Giulia", "initials": "G"}, {"family": "Lindh", "given": "Magnus", "initials": "M"}, {"family": "Peltola", "given": "Ville", "initials": "V"}, {"family": "Waris", "given": "Matti", "initials": "M"}, {"family": "Naucl\u00e9r", "given": "Pontus", "initials": "P"}, {"family": "M\u00e5rtensson", "given": "Andreas", "initials": "A"}, {"family": "Alfv\u00e9n", "given": "Tobias", "initials": "T", "orcid": "0000-0002-2328-3512", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/ec0459b52fbf486a9928024b29a595b5.json"}}], "type": "journal article", "published": "2021-04-14", "journal": {"title": "Vaccines (Basel)", "issn": "2076-393X", "volume": "9", "issue": "4", "issn-l": null}, "abstract": "(1) Immunization with pneumococcal conjugate vaccines has decreased the burden of community-acquired pneumonia (CAP) in children and likely led to a shift in CAP etiology. (2) The Trial of Respiratory infections in children for ENhanced Diagnostics (TREND) enrolled children 1-59 months with clinical CAP according to the World Health Organization (WHO) criteria at Sachs' Children and Youth Hospital, Stockholm, Sweden. Children with rhonchi and indrawing underwent \"bronchodilator challenge\". C-reactive protein and nasopharyngeal PCR detecting 20 respiratory pathogens, were collected from all children. Etiology was defined according to an a priori defined algorithm based on microbiological, biochemical, and radiological findings. (3) Of 327 enrolled children, 107 (32%) required hospitalization; 91 (28%) received antibiotic treatment; 77 (24%) had a chest X-ray performed; and 60 (18%) responded to bronchodilator challenge. 243 (74%) episodes were classified as viral, 11 (3%) as mixed viral-bacterial, five (2%) as bacterial, two (0.6%) as atypical bacterial and 66 (20%) as undetermined etiology. After exclusion of children responding to bronchodilator challenge, the proportion of bacterial and mixed viral-bacterial etiology was 1% and 4%, respectively. (4) The novel TREND etiology algorithm classified the majority of clinical CAP episodes as of viral etiology, whereas bacterial etiology was uncommon. Defining CAP in children <5 years is challenging, and the WHO definition of clinical CAP is not suitable for use in children immunized with pneumococcal conjugate vaccines.", "doi": "10.3390/vaccines9040384", "pmid": "33919904", "labels": [], "xrefs": [{"db": "pmc", "key": "PMC8070909"}, {"db": "pii", "key": "vaccines9040384"}], "notes": [], "created": "2026-08-21T13:05:22.842Z", "modified": "2026-08-21T13:05:23.105Z"}]}