title: Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae isolates causing invasive diseases from Shenzhen Children's Hospital.
abstract: OBJECTIVE
  To provide guidance for clinical disease prevention and treatment, this study examined the epidemiology, antibiotic susceptibility, and serotype distribution of Streptococcus pneumoniae (S. pneumoniae) associated with invasive pneumococcal diseases (IPDs) among children less than 14 years of age in Shenzhen, China.
  
  
  METHODS
  All the clinical strains were isolated from children less than 14 years old from January 2009 to August 2012. The serotypes and antibiotic resistance of strains of S. pneumoniae were determined using the capsular swelling method and the E-test.
  
  
  RESULTS
  A total of 89 strains were isolated and 87 isolates were included. The five prevailing serotypes were 19F (28.7%), 14 (16.1%), 23F (11.5%), 19A (9.2%) and 6B (6.9%). The most common sequence types (ST) were ST271 (21.8%), ST876 (18.4%), ST320 (8.0%) and ST81 (6.9%) which were mainly related to 19F, 14, 19A and 23F, respectively. The potential coverage by 7-, 10-, and 13-valent pneumococcal conjugate vaccine were 77.0%, 77.0%, and 89.7%, respectively. Among the 87 isolates investigated, 11.5% were resistant to penicillin, and for meningitis isolates, the resistance rate was 100%. Multi-drug resistance (MDR) was exhibited by 49 (56.3%) isolates. Eighty-four isolates were resistance to erythromycin, among which, 56 (66.7%) carried the ermB gene alone and 28 (33.3%) expressed both the ermB and mefA/E genes.
  
  
  CONCLUSIONS
  The potential coverage of PCV13 is higher than PCV7 and PCV10 because high rates of serotypes 19A and 6A in Shenzhen. The clinical treatment of IPD needs a higher drug concentration of antibiotics. Continued surveillance of the antimicrobial susceptibility and serotypes distribution of IPD isolates may be necessary.
authors.affiliation: Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Capital Medical University, Ministry of Education, Beijing Pediatrics Research Institute, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Ma
authors.forename: Ruizhen
authors.initials: R
authors.lastname: Zhao
authors.forename: Zhuoya
authors.initials: Z
authors.lastname: Ma
authors.forename: Kaihu
authors.initials: K
authors.lastname: Yao
authors.forename: Sangjie
authors.initials: S
authors.lastname: Yu
authors.forename: Yuejie
authors.initials: Y
authors.lastname: Zheng
authors.forename: Yonghong
authors.initials: Y
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002681:China; D004352:Drug Resistance, Microbial / Q000235:genetics*; D018432:Drug Resistance, Multiple / Q000235:genetics*; D006776:Hospitals, Pediatric; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000235:genetics* / Q000517:prevention & control; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000235:genetics* / Q000302:isolation & purification*
chemical_list: D000890:Anti-Infective Agents