A comparison of the distribution of pneumococcal types in systemic disease and the upper respiratory tract in adults and children.

The serotype distribution of 874 strains of Streptococcus pneumoniae was determined in relation to patients' age and to frequency of isolation from systemic disease. Types 14 and 18, in pre-school children, and types 1, 4, 7, 8 and 12 in patients over 5 years of age were significantly associated with systemic disease whereas type 23 in pre-school children, and type 6 in older patients was associated with upper respiratory tract carriage. No significant difference was found in the incidence of other types in systemic disease compared to upper respiratory tract carriage. Fifteen diagnostic pneumococcal antisera (to types 1, 3, 4, 6, 7, 8, 9, 11, 12, 14, 17, 18, 19, 22 and 23) sufficed for typing 87% of strains.