Genotype replacement within serotype 23F Streptococcus pneumoniae in Beijing, China: characterization of serotype 23F.

We investigated the genetic structure of 99 isolates of serotype 23F Streptococcus pneumoniae from children with acute respiratory infections collected over two periods from 1997 to 2006, and 2010. All isolates were susceptible to vancomycin and amoxicillin-clavulanic acid; 97 were resistant to erythromycin, 95 of which carried the ermB gene and two carried both mefA/E and ermB genes. Multidrug resistance to three or more classes of antibiotics was exhibited by 90 isolates. Sequence types ST342 and ST81 were the most frequent in 1997-2006 and 2010, respectively. All CC81 isolates were non-susceptible to β-lactam antibiotics and had higher minimum inhibitory concentration values for penicillin than other clone complexes and sequence types. The increased β-lactam antibiotic resistance may have resulted from the replacement of multidrug-resistant clones related to ST81. Long-term studies on S. pneumoniae serotype 23F, especially the ST81 clone, should be conducted to better understand the epidemiological picture of this pathogen in China.