{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T06:30:43Z","timestamp":1778999443447,"version":"3.51.4"},"reference-count":0,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2005,3,1]],"date-time":"2005-03-01T00:00:00Z","timestamp":1109635200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2005,3]]},"abstract":"\n In a survey of genetic diversity within penicillin-nonsusceptible pneumococcal isolates in Kenya, we examined 162 upper respiratory isolates from 104 human immunodeficiency virus (HIV)-infected adults and 46 children\nin a cotrimoxazole prophylaxis study. Antibiotic resistance levels were high; 152 (94.4%) were cotrimoxazole\nnonsusceptible (134 fully resistant) and 124 (77%) were intermediately penicillin resistant. Isolates\nnonsusceptible to penicillin and cotrimoxazole (PNCNP) were found among 24 of the 29 serotypes encountered,\n15 of which have rarely or never had documented nonsusceptibility to penicillin. These included\nserotypes 3, 4, 7C, 7F, 10A, 11A, 13, 15A, 15B, 16F, 17F, 19B, 21, 35A, and 35B. Segments of\n pbp2b<\/jats:italic>\n genes from 9 PNCNP (serotypes 3, 13, 15A, 16F, 20, and 35A) were typical of resistance-conferring alleles in that\nthey were highly divergent and contained two substitutions thought to be critical for resistance. Similarly, the\n dhfr<\/jats:italic>\n genes from 3 PNCNP were divergent and contained a substitution required for cotrimoxazole resistance. Multilocus sequence typing (MLST) of 48 PNCNP revealed 33 sequence types (STs), none of which were previously recorded at http:\/\/www.mlst.net. Comparisons with all known STs revealed that 23 of these STs were\nunrelated to other known STs, whereas 10 STs were highly related to STs from internationally disseminated\nstrains, including 2 of the 26 antibiotic-resistant clones recognized by the Pneumococcal Molecular Epidemiology\nNetwork. Based upon differing serotypes expressed by strains of identical or closely similar genotypes,\nthere has been an extensive history of capsular switching within seven genetic clusters represented by these\n10 STs and related STs described at http:\/\/www.mlst.net.\n <\/jats:p>","DOI":"10.1089\/mdr.2005.11.9","type":"journal-article","created":{"date-parts":[[2005,3,15]],"date-time":"2005-03-15T13:55:32Z","timestamp":1110894932000},"page":"9-17","source":"Crossref","is-referenced-by-count":18,"title":["Novel Antibiotic-Resistant Pneumococcal Strains Recovered from the Upper Respiratory Tracts of HIV-Infected Adults and Their Children in Kisumu, Kenya"],"prefix":"10.1177","volume":"11","author":[{"given":"Marie-Jo","family":"Medina","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA 30333."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn M.","family":"Greene","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA 30333."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert E.","family":"Gertz","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA 30333."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard R.","family":"Facklam","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA 30333."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geofrey","family":"Jagero","sequence":"additional","affiliation":[{"name":"Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Hamel","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA 30333."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya Ping","family":"Shi","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Kenya."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"Slutsker","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Kenya."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel R.","family":"Feikin","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Kenya."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Beall","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA 30333."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2005,3]]},"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2005.11.9","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2005.11.9","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:23:21Z","timestamp":1777667001000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1089\/mdr.2005.11.9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,3]]},"references-count":0,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2005,3]]}},"alternative-id":["10.1089\/mdr.2005.11.9"],"URL":"https:\/\/doi.org\/10.1089\/mdr.2005.11.9","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,3]]}}}