title: Serotypes of respiratory tract isolates of Streptococcus pneumoniae from Jamaican children.
abstract: BACKGROUND
  Data are lacking on the pneumococcal serotypes present in many developing regions, including the Caribbean. We examined the serotypes of nasopharyngeal (NP) isolates of pneumococci obtained from Jamaican children.
  
  
  METHODS
  We obtained NP samples from children seen in the Emergency Department at the Bustamante Children's Hospital. The samples were transported to Canada for isolation and serotyping of pneumococci.
  
  
  RESULTS
  We obtained 94 isolates from 276 children; median age 3.4 years. The majority (57%) had symptoms of acute respiratory infection at the time of sampling. The main serotypes carried were 6B (20.5%), 19F (14.5%), and 14 (8.4%). Non-typable isolates accounted for 10.8% of the isolates. Fifty-nine per cent of the serotypes were present among the 11 being considered for candidate pneumococcal conjugate vaccines (95% CI 48-70%); the corresponding proportion present in the recently licensed 7-valent vaccine was 57% (95% CI 45-67%). A significant proportion of the serotypes found is absent from those to be included in future conjugate vaccines (P<0.0001; reference=85% expected serotype representation). Less than 5% of isolates were non-susceptible to penicillin (3.2%), cefotaxime-ceftriaxone (3.2%) and cefuroxime (3.2%), while 8.4% and 1.l% of isolates were resistant to trimethoprim-sulfamethoxazole and erythromycin respectively. There were three isolates with resistance to two or more classes of drug. These isolates were all resistant to penicillin (MIC 2 micro g/mL); the serotypes were 14, 23F, and 19F.
  
  
  CONCLUSIONS
  A significant proportion of the serotypes found is absent from those to be included in future conjugate vaccines.
authors.affiliation: Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. upton.allen@sickkids.ca
authors.forename: Upton D
authors.initials: UD
authors.lastname: Allen
authors.forename: Sonia
authors.initials: S
authors.lastname: Thomas
authors.forename: Jonathan
authors.initials: J
authors.lastname: Carapetis
authors.forename: Sonia
authors.initials: S
authors.lastname: Henry
authors.forename: Samia
authors.initials: S
authors.lastname: Wasfy
authors.forename: Marguerite
authors.initials: M
authors.lastname: Lovgren
authors.forename: Susan
authors.initials: S
authors.lastname: Richardson
authors.forename: Donald E
authors.initials: DE
authors.lastname: Low
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001428:Bacterial Vaccines; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification*; D018074:Vaccines, Conjugate
chemical_list: D000900:Anti-Bacterial Agents; D001428:Bacterial Vaccines; D018074:Vaccines, Conjugate