小儿肺炎链球菌的耐药性及其血清学特征

目的　了解小儿肺炎链球菌的耐药性及其血清型分布情况 ,为小儿上呼吸道感染的临床抗生素合理治疗提供依据。　方法　肺炎链球菌自小儿上呼吸感染者的鼻咽拭子标本分离取得 ,并用标准 E- test法和琼脂稀释法测定其耐药性 ;采用 Quellung反应方法对其血清分型 ;采用 BOX- PCR和琼脂糖电泳技术对其进行基因特征分析。　结果　研究了 1999年至 2 0 0 1年期间从患儿鼻咽拭子标本中分离出来的 84株肺炎链球菌。 78.6% ( 66株 )的菌株对青霉素敏感 ,也同时对其他的 β-内酰胺类抗生素敏感。仅有 2 1.4 % ( 18株 )的菌株对青霉素耐药 ,其中 ,88.9% ( 16株 )的是低度耐药 ,11.1% ( 2株 )是高度耐药。几乎所有的菌株对利福平和万古霉素是敏感的。但大多数菌株对四环素、氯霉素、复方新诺明、红霉素表现出多重耐药性。占 60 .6%的肺炎链球菌其血清型是 6A( 14 .3 % )、2 3 F( 13 .1% )、19F( 11.9% )、15 B( 7.1% )、14( 7.1% ) ,不能分型 ( 7.1% ) ,而 18株青霉素耐药菌株的血清型是 2 3 F、19F、6B、14不能分型 ,以 2 3 F为主 ,它们有相似的BOX基因指纹图谱和耐药谱。　结论　本研究小儿肺炎链球菌对青霉素的耐药率较其他地区高 ,耐药模式以四环素、氯霉素、复方新诺明、红霉素、氯林可霉素为主。 2 3 F血清型是     

91株肺炎链球菌的血清型分布及耐药性分析

目的 了解重庆地区肺炎链球菌临床分离株的血清型分布及药物敏感性.方法 采用荚膜肿胀试验进行肺炎链球菌血清学分型,并计算疫苗(PVC7、PVC11、PVC13)覆盖率;肉汤稀释法测定抗菌药物的最低抑菌浓度(MIC).结果 91株肺炎链球菌的临床分离患者年龄呈典型双峰分布,以＜5岁婴幼儿与＞50岁中老年人群为主,占51.7％、27.5％;90株肺炎链球菌共鉴定出20个血清型,1株未能血清分型,常见的肺炎链球菌血清型为19F、19A、6B,PVC13覆盖率为74.4％;91株肺炎链球菌均表现出较高的耐药率,在67株β-内酰胺类抗菌药物不敏感株(BLAs)中,青霉素不敏感菌株(PNSP)占53.8％.结论 重庆地区肺炎链球菌临床分离株以19F、19A、6B血清型为主,PVC13的预防作用更显著;肺炎链球菌耐药性高尤其是大多数菌株呈多药耐药趋势,临床应注意合理选择用药.     

Emergence and spread of Streptococcus pneumoniae with erm(B) and mef(A) resistance

Streptococcus pneumoniae isolates (N = 31,001) were collected from patients with community-acquired respiratory tract infections during the PROTEKT US surveillance study (2000-2003). While the macrolide (erythromycin) resistance rate remained stable at approximately 29%, the prevalence of resistant isolates containing both erm(B) and mef(A) increased from 9.7% in year 1 to 16.4% in year 3, with substantial regional variability. Almost all (99.2%) dual erm(B) + mef(A) macrolide-resistant isolates exhibited multidrug resistance, whereas 98.6% and 99.0% were levofloxacin- and telithromycin-susceptible, respectively. These strains were most commonly isolated from the ear or middle-ear fluid of children. Of 152 representative erm(B)+mef(A) isolates, >90% were clonally related to the multidrug-resistant international Taiwan19F-14 clonal complex 271 (CC271). Of 366 erm(B)+mef(A) isolates from the PROTEKT global study (1999-2003), 83.3% were CC271, with the highest prevalence seen in South Africa, South Korea, and the United States. This study confirms the increasing global emergence and rapidly increasing US prevalence of this multidrug-resistant pneumococcal clone.     

Genetic relationship of penicillin resistant Streptococcus pneumoniae serotype 19B strains in Japan.

Pulsed field gel electrophoresis (PFGE) of the genomic DNA of penicillin resistant serotype 19B Streptococcus pneumoniae was carried out. Thirteen strains form the Nagasaki area and 12 strains from other areas in Japan were examined. Twenty-three strains were resistant to erythromycin, tetracycline and trimethoprim/sulfamethoxazole but susceptible to chloramphenicol. Eight strains were resistant to ceftriaxone. All strains were multiply resistant. Five strains isolated from Nagasaki were indistinguishable from each other by using restriction enzymes Apa I and Sma I. Two strains isolated from other areas were indistinguishable from the above five strains. We could classify 13 Nagasaki strains into 3 groups and the total of 25 Japanese strains into 6 groups. These results suggest that the increasing prevalence of multiply drug resistant S. pneumoniae serotyped 19B in Japan is not due to a single clone, but at least one clone has spread widely in Japan.     

马鞍山市肺炎链球菌血清型分布及耐药性分析

目的了解马鞍山地区肺炎链球菌临床分离株的血清型分布及药物敏感性。方法应用奥普脱欣试验及胆汁溶解试验鉴定肺炎链球菌;采用荚膜肿胀试验进行肺炎链球菌血清学分型,计算PPV23价疫苗及PCV7疫苗覆盖率;K-B法测定8种药物的耐药试验。结果 80株肺炎链球菌共鉴定13种血清型,有5株不能定型或群,马鞍山地区相对的优势血清型以19F、19A、23F为主,PPV23价疫苗可覆盖本次测试株的86.42%,PCV7疫苗可覆盖测试株的55.56%血清型;75株测试菌对青霉素等药物耐药率较高,耐受四种以上药物的菌株达60株,占测试菌株的80.00%,所有测试菌对左氧氟沙星和万古霉素全部敏感。结论马鞍山地区肺炎链球菌临床分离株以19F、19A、23F血清型为主,PPV23价疫苗的预防作用更显著;绝大多数肺炎链球菌呈多药耐药趋势,应注意合理用药。     

A multicenter hospital surveillance of invasive Streptococcus pneumoniae, Puerto Rico, 2001

Although antimicrobial resistance to Streptococcus pneumoniae has been increased dramatically worldwide, there is limited information of pattern of susceptibility for this pathogen in Puerto Rico. Hospital-based surveillance for invasive pneumococcal infections was begun among 38 hospitals island-wide in Puerto Rico from January to December, 2001. One hundred ninety-two cases of invasive pneumococcal disease were identified. Of the 177 isolates available for susceptibility testing, 50.3% were susceptible to penicillin and 49.7% were nonsusceptible (intermediate (I) and resistance (R)) (19.2% I, 30.5% R). Resistance was documented for expanded spectrum cephalosporins and macrolides. All isolates were susceptible to vancomycin. Diabetes, cardiovascular disease, smoking and bronchial asthma were the most common risk factors associated with invasive pneumococcal disease of the adult population. Bronchial asthma was the most common disease in the pediatric population with a fatality rate of 21%. There was no increased mortality detected among patients infected with penicillin resistant strains. Most of the isolates serotypes are represented in the 23-valent polysaccharide vaccine (78%) and 7-valent conjugate vaccine (62%). Penicillin-resistant isolates (47%) were 14, 19F, 6B, 6A, 9V, 23F, 19A and 35B serotype. Our data indicated a high prevalence for drug-resistant strains of S. pneumoniae in Puerto Rico. Continue surveillance for this common but serious pathogen is needed. Asthma is an important risk factor for pneumococcal disease. The pneumococcal vaccine should be recommended for all age groups with this risk factor.     

Pneumococcal serotype distribution and antimicrobial resistance in Chinese children hospitalized for pneumonia

A prospective study was performed to determine serotype distribution and antimicrobial resistance in Streptococcus pneumoniae (S. pneumoniae) from Chinese children <5 years old meeting pneumonia criteria. A total of 3865 children were enrolled and 338 S. pneumoniae isolates were obtained. The most frequent serotypes were 19F (55.6%), 19A (13.9%), 23F (10.1%), 6B (4.7%), and 14 (3.6%). The 7-, 10- and 13-valent conjugate vaccines, respectively, covered 76.3%, 76.9%, and 92.3% of isolates. Out of the isolates, six (1.8%) were penicillin resistant. All except 1 of the isolates were resistant to erythromycin. Serotype 19A showed the highest drug resistance. The use of PCV7 has the potential to prevent a substantial number of pneumococcal infections. However, PCV13 is likely to prevent more episodes of pneumococcal disease in China because of the high rates of 19A.     

河北省19F型和19A型侵袭性肺炎链球菌耐药性分析及多位点序列分型分析

目的 了解河北省侵袭性肺炎链球菌(Streptococcus pneumoniae,Spn)19F型和19A型的耐药特征及多位点序列分型(multilocus sequence type,MLST)分布.方法 19F 型和 19A 型采用多重聚合酶链式反应(multiplex polymerase chain reac...     

2017-2019年苏州地区儿童肺炎链球菌血清分型及耐药特征

  目的  了解苏州大学附属儿童医院呼吸道感染儿童肺炎链球菌菌株的血清型分布及耐药特征,为制定肺炎链球菌相关疾病的治疗和预防接种策略提供参考。  方法  采用乳胶凝集和荚膜肿胀试验对肺炎链球菌菌株进行血清分型,采用E-test法检测菌株对多种抗生素的耐药性。  结果  2017年1月-2019年7月共收集3 652株肺炎链球菌,主要来自于6月龄~2岁年龄段儿童,男女性别比为1.5:1。常见血清型为19F、6B、23F、19A及6A,13价肺炎球菌结合疫苗(13-valent pneumococcal conjugate vaccine, PCV13)的血清型覆盖率为73.1%(95% CI:71.6%~74.5%)。肺炎链球菌菌株对青霉素的耐药率为1.9%。青霉素不敏感肺炎链球菌(penicillin-non susceptible streptococcus pneumoniae, PNSP)(含中介和耐药菌株)对阿莫西林、红霉素、阿奇霉素等抗菌药物的耐药率高于青霉素敏感肺炎链球菌(penicillin-susceptible streptococcus pneumoniae, PSSP)菌株;PCV13疫苗血清型菌株的耐药率高于非疫苗血清型菌株。  结论  苏州地区儿童肺炎链球菌分离株PCV13疫苗血清型覆盖较高,且青霉素不敏感菌株大多为PCV13疫苗血清型。     

Fluoroquinolone and other antimicrobial resistance in invasive pneumococci, Hong Kong, 1995-2001

We determined the susceptibilities of 265 invasive isolates of pneumococci obtained during 1995 to 2001 in Hong Kong to 11 antimicrobial agents and their serotypes. Overall, 62.6% isolates were susceptible to penicillin, 20% were intermediately resistant, and 17.4% were resistant. The overall prevalence of levofloxacin resistance (MIC > or = 8 microg/mL) was 3.8% but increased to 15.2% among the penicillin-resistant isolates. All levofloxacin-resistant isolates were clonally related; had reduced susceptibility to penicillin, cefotaxime, and clarithromycin; and were derived from adults > or = 50 years of age. Of the penicillin-nonsusceptible pneumococci, 90% from children < or = 5 years of age and 54.8% from persons of all ages were of serotypes that are included in the 7-valent pneumococcal conjugate vaccine; 93.5% from children < or = 5 years of age and 93% from persons of all ages were of serotypes that are included in the 23-valent polysaccharide vaccine.     

Laboratory surveillance of invasive pneumococcal disease in Australia in 2001 to 2002--implications for vaccine serotype coverage.

This paper reports the results of comprehensive laboratory surveillance of invasive pneumococcal disease (IPD) in Australia during 2001 and 2002. The 7-valent conjugate pneumococcal vaccine was introduced for high risk paediatric groups, including Indigenous children, in late 2001. Of 1,355 isolates from non-Indigenous children, 86 per cent belonged to serotypes and 93 per cent to serogroups represented in the 7-valent pneumococcal conjugate vaccine. Thirteen per cent and 24 per cent of isolates had reduced susceptibility to penicillin and erythromycin, respectively and of these, more than 99 per cent belonged to serogroups represented in the 7-valent vaccine. Of the 1,504 isolates from non-Indigenous adults, 96 per cent belonged to serotypes included in the 23-valent polysaccharide vaccine; 14 per cent and 15 per cent had reduced susceptibility to penicillin and erythromycin, respectively and more than 95 per cent of these belonged to serotypes included in the 7-valent conjugate vaccine. In Western Australia and the Northern Territory (the only states for which Indigenous status was consistently available), there were 29 cases of IPD in Indigenous children, of which 21 were due to 7-valent vaccine serotypes in 2001, compared with 24 cases, including 10 due to vaccine serotypes, in 2002. This represents a statistically significant increase in the proportion of total isolates due to non-vaccine serotypes (chi2 = 3.93, p = 0.048) following the introduction of the 7-valent conjugate vaccine, principally due to serotypes 7F and 12F. The number of episodes due to penicillin resistant isolates decreased from nine in 2001 to two in 2002. Ninety per cent of isolates from Indigenous adults were included in the 23-valent polysaccharide vaccine and six per cent and five per cent had reduced susceptibility to penicillin and erythromycin, respectively. Conjugate pneumococcal vaccines can be expected to reduce the incidence of IPD due to vaccine serotypes in vaccinated children and potentially, their adult contacts. It may also impact favourably on the incidence of IPD due to penicillin and erythromycin resistant strains. Continued surveillance of both serotype distribution and antibiotic susceptibility are required to identify serotype replacement by non-vaccine serotypes and to monitor the overall impact of current and future vaccine programs on invasive pneumococcal disease in Australia.     

Current trend of pneumococcal serotypes distribution and antibiotic susceptibility pattern in Malaysian hospitals

From January 2008 to December 2009, 433 Streptococcus pneumoniae strains were examined to determine the serotype distribution and susceptibility to selected antibiotics. About 50% of them were invasive isolates. The strains were isolated from patients of all age groups and 33.55% were isolated from children below 5 years. The majority was isolated from blood (48.53%) and other sterile specimens (6.30%). Community acquired pneumonia (41.70%) is the most common diagnosis followed by sepsis (9.54%). Serotyping was done using Pneumotest Plus-Kit and antibiotic susceptibility pattern was determined by modified Kirby-Bauer disk diffusion method and measurement of minimum inhibitory concentration (MIC) using E-test strip. Ten most common serotypes were 19F (15.02%), 6B (10.62%), 19A (6.93%), 14 (6.70%), 1 (5.08%), 6A (5.08%), 23F (4.85%), 18C (3.93%), 3 (2.08%) and 5 (1.85%). Penicillin MIC ranged between ≤0.012-4 μg/ml with MIC₉₀ of 1 μg/ml. Penicillin resistant rate is 31.78%. The majority of penicillin less-susceptible strains belonged to serotype 19F followed by 19A and 6B. Based on the serotypes distribution 22 (44.00%), 28 (56.00%) and 39 (78.00%) of the invasive isolates from children ≤2 years were belonged to serotypes included in the PCV7, PCV10 and PCV13, respectively.     

241株肺炎链球菌血清分型及耐药性研究

目的了解肺炎链球菌（Streptococcus pneumoniae,S．p）对常用抗菌药物的敏感性及血清型构成。方法采用纸片扩散法检测241株S．P对6种常用抗菌药物的敏感性;采用荚膜肿胀试验对菌株进行血清学分型。结果241株s．p对利福平、米诺环素、氧氟沙星、复方新诺明、阿奇霉素、氯霉素的耐药率分别为0．41％、77．18％、0％、78．00％、95．44％、22．00％。229株S．P可分为24个血清型／群,主要的流行血清型／群为19F、6B、19A、23F、15、14、6A、3、6C;12株s．p未能分型。多重耐药菌株分布在6B、19A、19F、23F血清型。结论S．P的耐药情况严重,大多数菌株呈多重耐药特征。     

Characterization of Streptococcus pneumoniae invasive serotype 19A isolates recovered in Colombia

The aim of this study was to determine the molecular characterization of invasive penicillin non-susceptible Streptococcus pneumoniae serotype 19A isolates, collected in Colombia between 1994 and 2012. A total of 115 isolates serotype 19A were analyzed. Genetic relationship of 80 isolates with minimal inhibitory concentration (MIC) to penicillin ≥0.125 μg/was determined by pulsed-field gel electrophoresis (PFGE) and selected strains were studied by multilocus sequence typing (MLST). Among the 115 isolates, resistance to penicillin in meningitis was 64.2%, in non-meningitis 32.2% were intermediate and 1.1% were high resistance. The most frequent sequence types were ST320 (33.7%), ST276 (21.5%), and ST1118 (11.2%). Five isolates were associated with the Spain^9V-ST156 clone, and two isolates were related to Colombia^23F-ST338 clone. S. pneumoniae serotype 19A increased in Colombia was associated with the spread of isolates genetically related to ST320 and ST276, and emergence of capsular variants of worldwide-disseminated clones.     

Serotype distribution and antibiotic resistance of 140 pneumococcal isolates from pediatric patients with upper respiratory infections in Beijing, 2010

In the present study, the serotype distribution and antibiotic resistance of S. pneumoniae from pediatric patients with upper respiratory infections in Beijing, 2010 were described. 140 pneumococcal isolates were obtained, and the prevailing five serotypes were 19F (18.6%), 23F (9.3%), 14 (9.3%), 15 (9.3%), and 6A (7.1%). The vaccine coverage of PCV7, PCV10, and PCV13 were 43.6%, 43.6%, and 60.0%, respectively. According to the CLSI 2010 criteria, 99.3% of the S. pneumoniae isolates were susceptible to penicillin. The resistance rates to erythromycin and azithromycin were 96.4% and 97.1%, respectively. Meanwhile, 64.3% (90/140) of all pneumococcal isolates were multidrug-resistant S. pneumoniae (MDRSP). PCV13 covered 68.9% (62/90) of MDRSP strains, whereas it was 47.8% (43/90) for PCV7. ErmB was the dominant macrolide-resistance gene, whereas 30.4% pneumococcal isolates expressed both ermB and mefA. No isolate expressed ermTR. The potential coverage of PCV13 is higher than PCV7 and PCV10 because high rates of serotypes 6A and 19A, and the conjugate vaccines could prevent the spread of MDRSP. S. pneumoniae is still sensitive to penicillin. The resistance rate of S. pneumoniae to macrolides is high and ermB is the dominant macrolide-resistance gene in China, so continued surveillance of the antimicrobial susceptibility of S. pneumoniae may be necessary.     

Serotype competence and penicillin resistance in Streptococcus pneumoniae

From 2003 to 2005, we prospectively collected 118 isolates of pneumococci belonging to 7 serotypes to investigate their competence under the influence of the synthetic competence-stimulating peptides. The degree of competence of the various serotypes differed significantly. Serotype 6B had the highest competence, followed by serotypes 14, 19F, 9V, 23F, 3, and 18C. Isolates belonging to serotype 6B had greater genetic diversity than isolates belonging to serotype 3, which has high genetic clustering. Isolates belonging to serotypes 3 and 18C that were 100% sensitive to penicillin were significantly less competent than isolates belonging to serotypes 6B, 14, 19F, 9V, and 23F, which were frequently resistant to penicillin. Under the 7-valent pneumococcal conjugate vaccine program, enhanced molecular surveillance of virulent clones with higher competence to detect serotype switching will become more important.     

Emergence of multidrug-resistant Salmonella enterica serotype Typhi with decreased ciprofloxacin susceptibility in Bangladesh

During 1989-2002, we studied the antimicrobial resistance of 3928 blood culture isolates of Salmonella enterica serotype Typhi (S. Typhi) in Dhaka, Bangladesh. Overall 32% (1270) of the strains were multidrug-resistant (MDR, resistant to chloramphenicol, ampicillin and trimethoprim-sulphamethoxazole); first detected in 1990 (rate of 8%), increased in 1994 (44%), declined in 1996 (22%, P<0.01 compared to 1994) and re-emerged in 2001 (36%) and 2002 (42%, P<0.01 compared to 1996). An increased MIC of ciprofloxacin (0.25 microg/ml) indicating decreased susceptibility to ciprofloxacin was detected in 24 (18.2%) out of 132 randomly selected strains during 1990-2002; more frequently in MDR than susceptible strains (46.3% vs. 5.5%, P<0.001), and the proportion of them rose to 47% in 2002 from 8% in 2000 (P<0.01). Ciprofloxacin (5 microg) disk diffusion zone diameters of < or =24 mm as break-point had 98% sensitivity and 100% specificity when compared with a ciprofloxacin MIC of 0.25 microg/ml as break-point for decreased susceptibility; being a useful and easy screen test. All strains were susceptible to ceftriaxone. The emergence of MDR S. Typhi with decreased ciprofloxacin susceptibility will further complicate the therapy of typhoid fever because of the lack of optimum treatment guidelines.     

Susceptibility to antimicrobial agents in isolates from invasive Streptococcus pneumoniae in Colombia]

A study was done to determine the patterns of susceptibility to antimicrobial agents in isolates of Streptococcus pneumoniae that caused invasive disease diagnosed in children under the age of 5 in Colombia between 1994 and 1996, as well as to establish the distribution of the capsular types of the resistant isolates. The analysis was done using 324 isolates obtained during the performance of the National Serotyping Protocol for S. pneumoniae carried out in Bogotá, Medellín, and Cali, Colombia, between July 1994 and March 1996. Of the 324 isolates, 119 (36.7%) showed diminished susceptibility to at least one antimicrobial agent, including 39 (12%) that showed diminished susceptibility to penicillin. Of these 39 resistant to penicillin, 29 showed intermediate resistance and 10 showed high resistance. Nine isolates (2.8%) showed resistance to ceftriaxone, 80 (24.7%) to the combination of trimethoprim and sulfamethoxazole (TMS), 49 (15.1%) to chloramphenicol, and 31 (9.6%) to erythromycin. Resistance to two antimicrobial agents was observed in 31 isolates (9.6%); multiple resistance was found in 22 (6.7%). These 22 multiresistant isolates all showed resistance to TMS. The most frequent associations were penicillin, TMS, and erythromycin (5 cases); penicillin, chloramphenicol, TMS, and erythromycin (4 cases); penicillin, ceftriaxone, chloramphenicol, and TMS (3 cases); and penicillin, ceftriaxone, chloramphenicol, TMS, and erythromycin (3 cases). The most frequent serotypes in the penicillin-resistant isolates were: 23F (53.8%), 14 (25.6%), 6B (7.7%), 9V (5.1%), 19F (5.1%), and 34 (2.6%). The most frequent serotypes in the isolates resistant to antimicrobial agents other than penicillin were: 5 (37.5%), 23F (7.5%), 14 (18.8%), and 6B (13.8%). This difference in the distribution of the serotypes was statistically significant (P < 0.0001). The study results indicate the need to maintain active surveillance of antibiotic susceptibility patterns in order to avoid resistance in S. pneumoniae and to provide timely information to change practices regarding prescribing and consuming antimicrobial agents.     

接种13价肺炎球菌结合疫苗对就诊儿童肺炎链球菌血清型和耐药性的影响

  目的  了解就诊儿童肺炎链球菌(Streptococcus pneumoniae, Spn)血清型分布和耐药特征,探索接种13价肺炎球菌结合疫苗(13-valent pneumococcal conjugate vaccine, PCV13)对Spn的影响。  方法  收集2017—2019年苏州大学附属儿童医院疫苗接种信息明确的就诊儿童的Spn菌株,根据疫苗接种情况进行分组,并采用荚膜肿胀法进行血清分型,E-test法检测菌株抗生素的耐药性,比较是否接种PCV13对Spn血清型和耐药性的差别。  结果  共收集692株Spn,其中20株分离自接种PCV13儿童。接种组中常见的血清型为19F、6B、19A、23F,对照组中常见的血清型为19F、6B、23F、19A、14,两组血清型分布差别无统计学意义(P=0.868),PCV13血清型覆盖率分别为70.0% 和72.4%(P=0.491)。所有菌株对红霉素、四环素、克林霉素高度耐药,且多重耐药率达98.5%。接种组和对照组的Spn菌株对青霉素的不敏感率分别为5.0%和9.1%(P=0.804)。  结论  苏州大学附属儿童医院监测就诊儿童Spn血清型以PCV13覆盖的血清型为主,菌株对β-内酰胺类抗生素的耐药性有所下降,但对红霉素等其他常用抗菌药物的耐药性依旧严峻,并存在大量的多重耐药情况。尚未观察到接种PCV13对菌株血清型分布及降低抗生素耐药性的明显效果。     

Serotype distribution and antimicrobial resistance patterns of nasopharyngeal and invasive Streptococcus pneumoniae isolates in Hong Kong children

A study was conducted to determine the vaccine coverage of prevalent carriage and invasive pneumococci from children aged less than 6 years in Hong Kong. A total of 383 nasopharyngeal carriage isolates and 88 invasive isolates from diverse sources were serotyped and their antimicrobial susceptibilities determined. The most common carriage serotypes were the same as the invasive isolates (6B, 14, 19F and 23F), although the rank order of specific serotypes was different. Serotypes in the 7-valent conjugate pneumococcal vaccine (4, 6B, 9V, 14, 18C, 19F and 23F) accounted for 89.7 and 66.1% of the invasive and carriage isolates, respectively. The same seven serotypes comprised 87.5% invasive isolates and 82.8% carriage isolates with resistance to penicillin, erythromycin and/or cefotaxime.