title: Serotype distribution and antibiotic resistance of Streptococcus pneumoniae isolates collected at a Chinese hospital from 2011 to 2013.
abstract: BACKGROUND
  Streptococcus pneumoniae infections are a major cause of global morbidity and mortality, and the emergence of antibiotic-resistant Streptococcus pneumoniae strains has been increasingly reported. This study provides up-to-date information on bacterial serotype distribution and drug resistance from S. pneumoniae clinical isolates that could guide prevention and treatment strategies for pneumococcal disease in China.
  
  
  METHODS
  A total of 94 S. pneumoniae isolates were collected from outpatients and inpatients at one Chinese hospital from 2011-2013. Drug susceptibility and resistance was determined by minimum inhibitory concentrations (MICs). Capsular serotypes were identified by the quellung reaction test and multiplex polymerase chain reaction.
  
  
  RESULTS
  Fifteen serotypes were identified among the 94 S. pneumoniae clinical isolates that were collected. Prevalent serotypes were 19F (42.6 %), 19A (8.5 %), 3 (8.5 %), and 6B (7.4 %). Potential immunization coverage rates for the 7-, 10- and 13-valent pneumococcal polysaccharide conjugate vaccines were 59.6, 62.6, and 79.6 %, respectively. Resistance rates to tetracycline, erythromycin, and trimethoprim/sulfamethoxazole were 91.2, 80.2 and 63.8 %, respectively. Resistance rates to penicillin, amoxicillin, ceftriaxone, and cefotaxime were 47.3, 34.1, 19.8, and 18.7 %, respectively. In almost all cases, antimicrobial resistance of the S. pneumoniae isolates in patients five years or younger was higher than isolates collected from patients aged 51 years or older.
  
  
  CONCLUSIONS
  Prevalent serotypes among the 94 S. pneumoniae clinical isolates were 19F, 19A, 3, and 6B. The 13-valent pneumococcal polysaccharide conjugate vaccine covered the majority of the serotypes identified in this sample. Drug resistance varied among different serotypes and age groups. Clinical precautions should be taken to avoid the development of multidrug resistance in this potential human pathogen.
authors.affiliation: Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China. hsongyin@126.com.
authors.forename: Songyin
authors.initials: S
authors.lastname: Huang
authors.affiliation: Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China. liu_1507@163.com.
authors.forename: Xiaoqiang
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China. laoweisi@21cn.com.
authors.forename: Weisi
authors.initials: W
authors.lastname: Lao
authors.affiliation: Department of Ophthalmic Surgery, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China. zeng1507@163.com.
authors.forename: Suhua
authors.initials: S
authors.lastname: Zeng
authors.affiliation: Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China. 846833194@qq.com.
authors.forename: Huiqi
authors.initials: H
authors.lastname: Liang
authors.affiliation: Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China. 13570217766@139.com.
authors.forename: Rihui
authors.initials: R
authors.lastname: Zhong
authors.affiliation: Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China. 443848397@qq.com.
authors.forename: Xinlu
authors.initials: X
authors.lastname: Dai
authors.affiliation: Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China. xiquan_wu@126.com.
authors.forename: Xiquan
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China. lehyu@126.com.
authors.forename: Hongyu
authors.initials: H
authors.lastname: Li
authors.affiliation: Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China. yyandan@126.com.|Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China. yyandan@126.com.|General Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China. yyandan@126.com.
authors.forename: Yandan
authors.initials: Y
authors.lastname: Yao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents; D002648:Child; D002681:China / Q000453:epidemiology; D004269:DNA, Bacterial / Q000032:analysis / Q000378:metabolism; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D011008:Pneumococcal Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D022242:Pneumococcal Vaccines / Q000276:immunology; D015995:Prevalence; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000235:genetics* / Q000276:immunology / Q000302:isolation & purification; D018074:Vaccines, Conjugate / Q000276:immunology; D055815:Young Adult
chemical_list: C538862:13-valent pneumococcal vaccine; D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate