title: Phenotypic and genotypic characteristic of invasive pneumococcal isolates from both children and adult patients from a multicenter surveillance in China 2005-2011.
abstract: Streptococcus pneumoniae is an important pathogen in both children and the elderly, but previous studies in China have provided limited information about invasive pneumococcal disease (IPD). A total of 240 IPD S. pneumoniae strains (from 105 children and 135 adults) were collected from 12 cities in China in 2005-2011. Their phenotypes and genetic characteristics were analyzed. Streptococcus pneumoniae remained highly resistant to macrolides, tetracycline, and cotrimoxazole each year. Serotypes were assigned to the 240 isolates, and 19A (22.1%), 19F (21.7%), 14 (7.5%), 3 (7.1%), and 23F (5.4%) were the most prevalent, accounting for 63.8% of all strains. Serogroup 19 strains were significantly more common among children than among adults (58.7% vs 32.4%, respectively; P < 0.001). Serotypes 19F and 19A demonstrated higher resistance to β-lactams and cephalosporins than the other serotypes. The coverage of PCV13 was superior to that calculated for PCV7 and PCV10 (77.9% vs 40.8% and 47.1%, respectively), and coverage was higher in children than in adults (85.6% vs 72.1%, respectively; P = 0.012). A multilocus sequence typing analysis revealed great diversity, with nine clonal complexes and 83 singletons among all the strains. Specifically, CC271 was more common in children, whereas singletons were more prevalent in adults. Among the serogroup 19 strains, 84.7% were ST271, ST320, or ST236, belonging to CC271. The homogeneous genetic background of 19F and 19A, together with the high resistance of these strains, suggests that clonal spread is responsible for the high prevalence of serogroup 19 in IPD. This is the first large study to investigate IPD strains in both children and adults in China.
authors.affiliation: Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China.
authors.forename: Chunjiang
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China.
authors.forename: Feifei
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Clinical Laboratory, the First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Yunzhuo
authors.initials: Y
authors.lastname: Chu
authors.affiliation: Department of Clinical Laboratory, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital of Capital Medical University, Beijing, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Cao
authors.affiliation: Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Minjun
authors.initials: M
authors.lastname: Chen
authors.affiliation: The First Affiliated Hospital of Medical School of Hangzhou University, Hangzhou, Zhejiang, China.
authors.forename: Yunsong
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Sun Yatsen University, Guangzhou, Guangdong, China.
authors.forename: Kang
authors.initials: K
authors.lastname: Liao
authors.affiliation: Department of Clinical Laboratory, Guangdong General Hospital, Guangzhou, Guangdong, China.
authors.forename: Liyan
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Tongji Hospital, Tongji Medical College Huazhong University of Science & Technology, Wuhan, Hubei, China.
authors.forename: Ziyong
authors.initials: Z
authors.lastname: Sun
authors.affiliation: Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Bijie
authors.initials: B
authors.lastname: Hu
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
authors.forename: Jin'e
authors.initials: J
authors.lastname: Lei
authors.affiliation: Department of Clinical Laboratory, General Hospital, Tianjin Medical University, Tianjin, China.
authors.forename: Zhidong
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Department of Clinical Laboratory, Southwest Hospital, Chongqing, China.
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D002947:Cities; D024881:Drug Resistance, Bacterial / Q000187:drug effects; D005838:Genotype; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D058885:Multilocus Sequence Typing; D010641:Phenotype; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000276:immunology; D011159:Population Surveillance; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D022242:Pneumococcal Vaccines