Investigation of Antibiotic Resistance, Serotype Distribution, and Genetic Characteristics of 164 Invasive Streptococcus pneumoniae from North China Between April 2016 and October 2017

Figures & data

Table 1 Characteristics of 164 Invasive Streptococcus pneumoniae Strains from 2018 in North China

Characteristics	Groups	Number of Strains	Percentage
Age	<36 month	95	57.9
	3–5 years	34	20.7
	6–17 years	11	6.7
	18–60 years	12	7.3
	>60 years	12	7.3
Gender	Male	93	56.7
	Female	71	43.3
Specimen type	Blood	124	75.6
	Cerebrospinal fluid	34	20.7
	Pleural fluid	6	3.7
Type of medical institution	Children and Maternal	109	66.5
	General	55	33.5
Ward type	Outpatient	8	4.9
	Inpatient	122	74.4
	ICU	34	20.7
Departments	Neurology	37	22.6
	Pediatrics ICU	33	20.1
	Respiratory	24	14.6
	Hematology	19	11.6
	Pediatrics	12	7.3
	Emergency department	7	4.3
	Nephrology	7	4.3
	Cardiology	6	3.7
	Other	19	11.6
PCV-10	Covered	98	59.8
	Non-covered	66	40.2
PCV-13	Covered	124	75.6
	Non-covered	40	24.4
PCV-10 covered	PRSP	64	65.3 (64/98)
PCV-10 non-covered	PRSP	29	43.9 (29/66)
PCV-13 covered	PRSP	81	65.3 (81/124)
PCV-13 non-covered	PRSP	12	30.0 (12/40)

Table 2 The Proportion of Different IPD Types in Different Age Groups

Specimen Type	<36 Months (95)	3–5 Years (34)	6–17 Years (11)	18–60 Years (12)	>60 Years (12)
Blood	75.8	79.4	45.5	91.7	75.0
Cerebrospinal fluid	22.1	8.8	54.5	8.3	25.0
Pleural	2.1	11.8	0.0	0.0	0.0

Table 3 Susceptibility of Invasive Streptococcus pneumoniae to Routine Clinical Antibiotics

Antibiotics	%R	%I	%S	MIC50	MIC90	Range	%R (N)
							PRSP (93)	PISP (38)	PSSP (33)	Age <18 (140)	Age ≥18 (24)	Children and Maternal (109)	General (55)
Penicillin V oral	56.7	23.2	20.1	2	4	0.004–8	100	0.0	0.0	62.9	20.8	61.5	47.3
Penicillin G meningitis	79.9	0.0	20.1	2	4	0.004–8	100	100	0.0	83.6	58.3	81.7	76.4
Penicillin G non-meningitis	1.2	18.9	79.9	2	4	0.004–8	2.2	0.0	0.0	1.4	0.0	0.9	1.8
Amoxicillin/Clavulanic acid	20.7	13.4	65.9	1	8	0.008–32	36.6	0.0	0.0	22.9	8.3	22.9	16.4
Cefaclor	78.0	9.1	12.8	256	256	0.016–256	100	92.1	0.0	82.1	54.2	79.8	74.5
Cefuroxime	62.8	9.8	27.4	4	16	0.016–128	97.8	31.6	0.0	67.9	33.3	65.1	58.2
Ceftriaxone non-meningitis	9.1	4.3	86.6	0.5	2	0.016–8	15.1	2.6	0.0	10.0	4.2	9.2	9.1
Ceftriaxone meningitis	13.4	29.3	57.3	0.5	2	0.016–8	22.6	2.6	0.0	15.0	4.2	12.8	14.5
Vancomycin	0.0	0.0	100	0.25	0.25	0.016–0.5	0.0	0.0	0.0	0.0	0.0	0	0.0
Erythromycin	98.2	0.0	1.8	128	256	0.016–256	100	97.4	93.9	97.9	100	98.2	98.2
Azithromycin	97.6	0.6	1.8	256	256	0.016–256	100	94.7	93.9	97.1	100	98.2	96.4
Clarithromycin	98.2	0.0	1.8	256	256	0.25–256	100	97.4	93.9	97.9	100	98.2	98.2
Tetracycline	94.5	1.2	4.2	32	64	0.016–128	95.7	94.7	90.9	94.3	95.8	95.4	92.7
Levofloxacin	1.2	0.0	98.8	1	1	0.016–16	1.1	2.6	0.0	0.0	8.3	0	3.6
Moxifloxacin	0.0	1.2	98.8	0.125	0.125	0.016–2	0.0	0.0	0.0	0.0	0.0	0	0.0
Trimethoprim/Sulfamethoxazole	59.8	7.3	32.9	4	16	0.016–256	73.1	52.6	30.3	61.4	50.0	58.7	61.8
Chloramphenicol	7.3	0.0	92.7	4	4	0.016–16	5.4	2.6	18.2	4.3	25.0	4.6	12.7
Clindamycin	96.3	0.6	3.0	256	256	0.016–256	100	92.1	90.9	96.4	95.8	97.2	94.5

Figure 1 Resistance of S. pneumoniae to routine antibiotics in different age groups.

Figure 2 Resistance of S. pneumoniae to routine antibiotics against different serotypes.

Table 4 Sequence Types, Serotypes, Antibiotic Resistance Rates (%), and Age Distributions for 164 Streptococcus pneumoniae Isolates Analyzed by MLST

Clonal Complex	STs	Number	Serotypes (Number)	Resistance Rates of Different Antibiotics (%)			Number of Strains in Different Ages
				Penicillin	Azithromycin	Levofloxacin	<36 Months	3–5 Years	6–17 Years	18–60 Years	>60 Years
CC320	271	22	19F (21), 19A (1)	90.9	100	0	15	3	3	1	0
CC320	320	14	19A (14)	100	100	0	9	4	0	0	1
CC320	236	4	19F (4)	25	100	0	2	0	0	2	0
CC320	1937	1	19F (1)	100	100	0	1	0	0	0	0
CC876	876	28	14 (28)	60.7	100	0	16	7	1	1	3
CC876	200	1	14 (1)	100	100	0	1	0	0	0	0
CC81	81	17	N23F (7), 23F (9), NVT (1)	94.1	100	0	8	6	2	1	0
CC81	83	1	N23F (1)	100	100	0	1	0	0	0	0
CC180	180	3	NVT (3)	0	100	0	0	1	0	2	0
CC180	12,098	1	3 (1)	0	100	0	0	0	0	1	0
CC505	505	4	NVT (4)	0	100	0	2	2	0	0	0
CC2987	1263	2	9V (2)	0	100	0	2	0	0	0	0
CC2987	6011	1	15 (1)	0	100	0	1	0	0	0	0
CC615	2296	3	1 (3)	0	100	0	2	1	0	0	0
CC870	870	2	18C (2)	0	100	0	2	0	0	0	0
CC9765	3397	2	15 (2)	0	50	0	1	1	0	0	0
CC143	143	1	14 (1)	100	100	0	1	0	0	0	0
CC156	156	1	9V (1)	100	100	0	0	0	1	0	0
CC156	166	1	9V (1)	100	100	0	1	0	0	0	0
CC878	878	1	N23F (1)	0	100	0	0	0	0	0	1
CC230	2707	1	NVT (1)	0	100	0	0	0	0	1	0
Singletons	13,646	6	23F (5), N23F (1)	0	100	0	3	2	1	0	0
Singletons	2248	5	14 (5)	100	100	0	4	1	0	0	0
Singletons	10,088	4	NVT (3), 15 (1)	0	100	0	4	0	0	0	0
Singletons	3173	3	6A (1), 6B (2)	100	100	0	2	1	0	0	0
Singletons	790	2	14 (2)	50	100	0	1	1	0	0	0
Singletons	6945	2	NVT (2)	0	100	0	0	0	0	2	0
Singletons	8738	2	6B (2)	100	100	0	2	0	0	0	0
Singletons	9017	2	6A (2)	0	100	0	2	0	0	0	0
Singletons	11,967	2	7F (2)	50	100	100	0	0	0	0	2
Singletons	12,902	2	3 (2)	0	100	0	0	0	0	1	1
Singletons	872	1	N23F (1)	100	100	0	1	0	0	0	0
Singletons	Others	22	NVT (9), 6A (3), 6B (2), 18C (2), 19F (1), 19A (1), 23F (1), N23F (1),15 (1), 3 (1),	27.3	86.4	0	11	4	3	0	4

Figure 3 Phylogenetic tree of 164 invasive S. pneumoniae strains generated using the PHYLOViZ online application.