Antimicrobial resistance and serotypes of nasopharyngeal strains of Streptococcus pneumoniae in Chinese children with acute respiratory infections

This prospective, multicentre, nasal carriage study in Chinese children with upper respiratory infection was carried out over the period from 2000 to 2002. Overall, the prevalence of pneumococcal. carriage was 24.9%. Antimicrobial susceptibility tests were performed for 887 isolates of Streptococcus pneumoniae of which 33.5% were intermediately susceptible to penicillin and 6.4% were resistant. Multidrug resistance was very common. Pneumococcal strains (n = 625) were serotyped, showing 72.2% were covered by the 23-valent pneumococcal polysaccharide vaccine and 57.6% by the seven-valent pneumococcal conjugate vaccine. Serogroups 19 and 23 were significantly associated with penicillin resistance, which is increasing in China. Erythromycin, tetracycline and sulphamethoxazole/trimethoprim cannot be recommended as first-line treatments for respiratory tract infection as in some other developing countries. These features of serotype distribution are of importance for surveillance in the era of the new conjugate vaccine. In particular, these features will allow for documentation of serotype replacement after the introduction of widespread vaccination.