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Open research questions in Pneumonia and Respiratory Infections

163 unresolved questions extracted from the limitations and future-work sections of 668 Pneumonia and Respiratory Infections papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • The study highlights the need to improve caregivers' healthcare seeking behaviour and appropriate case management at health facilities. Delays in seeking care for childhood pneumonia result in prolonged hospital stays. The study aims to address the gap in understanding caregivers' delays and barriers to prompt care-seeking.

    Levels and determinants of healthcare-seeking delay for pediatric pneumonia: a mixed-methods study · 2026 · DOI

  • The study identifies a gap in knowledge regarding pneumococcal colonization in adults with viral respiratory infections. Prior studies have focused on children, and there is a need for more research on adults. The study highlights the importance of considering pneumococcal colonization in adults with viral respiratory infections, particularly in those with underlying conditions.

    Hidden burden of pneumococcal colonization in adults with viral respiratory infections: the role of influenza and RSV · 2026 · DOI

  • Further research is needed to validate the models, - Investigation of the shared pathological basis underlying RMPP and corticosteroid treatment escalation

    Prediction models for refractory Mycoplasma pneumoniae pneumonia and corticosteroid treatment escalation in hospitalized children: a retrospective cohort study · 2026 · DOI

  • Lack of a validated admission-day prediction tool for refractory MPP or corticosteroid treatment escalation. Need for a model that can identify children at risk for these outcomes using routine clinical and laboratory variables.

    Prediction models for refractory Mycoplasma pneumoniae pneumonia and corticosteroid treatment escalation in hospitalized children: a retrospective cohort study · 2026 · DOI

  • Retrospective study design, - Single-center study, - Limited sample size of 318 patients for S. pneumoniae and 335 patients for L. pneumophila, - Discordant results may be due to specimen handling rather than true differences between methods

    Inter-platform agreement and diagnostic performance of the automated LIAISON® chemiluminescence immunoassay vs. the Sofia® fluorescence immunoassay for Streptococcus pneumoniae and Legionella pneumophila urinary antigen detection · 2026 · DOI

  • Further studies to compare the performance of different urinary antigen tests, - Investigation into the causes of discordant results between different assays, - Evaluation of the clinical impact of using different assays for diagnosing S. pneumoniae and L. pneumophila

    Inter-platform agreement and diagnostic performance of the automated LIAISON® chemiluminescence immunoassay vs. the Sofia® fluorescence immunoassay for Streptococcus pneumoniae and Legionella pneumophila urinary antigen detection · 2026 · DOI

  • One challenge is the complexity of the immune response to SARS-CoV-2 and Spn co-infection. Another challenge is the difficulty of modeling human disease in a mouse model. A third challenge is the need to quantify and characterize the role of pneumolysin in disease severity and lung pathology.

    Pneumolysin Attenuates Lethal Streptococcus pneumoniae Superinfection Following SARS-CoV-2 Infection · 2026 · DOI

  • Limited access to healthcare and vaccination in low-and lower-middle-income countries. Difficulty in obtaining nasopharyngeal samples from children and adults. Challenge of interpreting antibiotic susceptibility testing results in the context of pneumococcal disease.

    Streptococcus pneumoniae carriage, antimicrobial resistance, and serotype distribution in children and adults from Paraguay in the post-vaccinal era · 2025 · DOI

  • Data from many low-and lower-middle-income countries remain limited or poorly characterized, - The study only included healthy children and adults living in the same household, - The study did not include data from other countries or regions

    Streptococcus pneumoniae carriage, antimicrobial resistance, and serotype distribution in children and adults from Paraguay in the post-vaccinal era · 2025 · DOI

  • Bacteriocins are key mediators of intra-species competition, yet many of their functions and regulatory mechanisms remain poorly understood.

    Rgg 144 /SHP 144 -controlled streptolancidin D mediates intra-species competition in Streptococcus pneumoniae with cumulative effect from other bacteriocins and fratricide · 2026 · DOI

  • While several pneumococcal bacteriocins have been characterized, the functions of many remain unknown, limiting our understanding of how these systems shape strain fitness and population dynamics.

    Rgg 144 /SHP 144 -controlled streptolancidin D mediates intra-species competition in Streptococcus pneumoniae with cumulative effect from other bacteriocins and fratricide · 2026 · DOI

  • However, the mechanisms underlying the severe disease caused by SARS-CoV-2 and Spn co-infection remain poorly understood.

    Pneumolysin Attenuates Lethal Streptococcus pneumoniae Superinfection Following SARS-CoV-2 Infection · 2026 · DOI

  • Bronchial mucus plugs appear to play a key role; however, their risk factors and underlying mechanisms remain incompletely defined.

    Immune activation and mucin dysregulation in pediatric refractory Mycoplasma pneumoniae pneumonia with mucus plugs · 2026 · DOI

  • However, the epidemiological landscape of MP in coastal regions during the post-COVID-19 era remains poorly characterized.

    Post-pandemic resurgence of Mycoplasma pneumoniae in coastal China: from seasonal waves to sustained transmission and expanded age susceptibility · 2026 · DOI

  • pneumoniae, as well as the prospects for therapies and vaccines targeting this mechanism, remains incompletely defined.

    Advances in adhesion-related pathogenesis in Mycoplasma pneumoniae infection · 2025 · DOI

  • pneumoniae ) is a leading pathogen of pediatric pneumonia, yet its epidemiological profile in Chengdu remains understudied.

    Positive rates of Mycoplasma pneumoniae antibodies in children before, during and after COVID-19 outbreak: an observational study in Chengdu, China from 2017 to 2024 · 2025 · DOI

  • The mortality of pulmonary embolism in children is high, and there is no standardized treatment protocol.

    Successful rivaroxaban and doxycycline therapy for Mycoplasma pneumonia with pulmonary embolism in children: a case report · 2025 · DOI

  • However, the impact of conjugation-induced structure changes in pneumococcal polysaccharides on clinical immunogenicity is not clearly understood.

    Generating a panel of clinically relevant monoclonal antibody to monitor conjugation conditions for pneumococcal polysaccharide vaccines 9261 · 2025 · DOI

  • Co-infection of Streptococcus pneumoniae with respiratory viruses is associated with increased disease severity, but its relationship with SARS-CoV-2 remains unclear.

    SARS-CoV-2 and Streptococcus pneumoniae colonization and disease: an observational study in adults · 2025 · DOI

  • Background The host’s immune status is a critical determinant of the pathogen profile in pulmonary infections, but quantitative indicators to delineate this dynamic association are lacking.

    CD4+ T cells stratification unveils a dynamic pathogen landscape in severe pneumonia: a targeted next-generation sequencing-based cohort study · 2025 · DOI

  • The impact of these coinfections on disease severity and mortality rates remains underexplored.

    Coinfection with SARS-CoV-2 among patients with Streptococcus pneumoniae in Casablanca · 2025 · DOI

  • Although vaccines have effectively reduced disease worldwide, data on adult serotype distribution and resistance in China are scarce.

    Distribution of serotypes and antibiotic resistance profiles of Streptococcus pneumoniae in hospitalized adult patients: aretrospective multicenter surveillance in China (2018–2019) · 2025 · DOI

  • Nigeria introduced PCV10 in 2016, but its impact on serotype distribution and resistance in Delta State remains poorly defined.

    Serotype distribution and antimicrobial susceptibility patterns of Streptococcus pneumoniae isolates in the post–pneumococcal conjugate vaccine era in Nigeria: a hospital-based cross-sectional study · 2025 · DOI

  • However, the epidemiological differences of Mycoplasma pneumoniae (MP) between the two phases in Ningbo and even in China remain unclear.

    Influence of non-pharmaceutical interventions on epidemiological characteristics of Mycoplasma pneumoniae infection in children during and after the COVID-19 epidemic in Ningbo, China · 2024 · DOI

  • Pneumolysin (Ply) of Streptococcus pneumoniae (pneumococcus) at relatively high and low levels facilitates pneumococcal invasion into the lung and brain, respectively; however, the regulatory mechanisms of Ply expression are poorly understood.

    A 3’UTR-derived small RNA represses pneumolysin synthesis and facilitates pneumococcal brain invasion · 2024 · DOI

Most-cited papers in Pneumonia and Respiratory Infections

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163 open questions have been extracted from the limitations and future-work passages of 668 Pneumonia and Respiratory Infections papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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