{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:24:57Z","timestamp":1777922697895,"version":"3.51.4"},"reference-count":62,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2014,10,1]],"date-time":"2014-10-01T00:00:00Z","timestamp":1412121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:p>\n                    Distribution of serotypes, prevalence of resistance to penicillin and\/or erythromycin (EM), and its genetic traits were analyzed for a total of 1,061 noninvasive or colonization isolates of\n                    <jats:italic toggle=\"yes\">Streptococcus pneumoniae<\/jats:italic>\n                    (998 and 61 isolates from children and adults, respectively) in Hokkaido, northern main island of Japan, in the year 2011, the pre-PCV7 routine immunization period. Serotype deduction was performed by sequential multiplex polymerase chain reaction (PCR), employing mutagenic PCR-restriction fragment length polymorphism for discrimination of 6A\/C and 6B\/D. Unaltered three PBP genes and macrolide resistance genes\n                    <jats:italic toggle=\"yes\">erm(B)<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">mef(A\/E)<\/jats:italic>\n                    were detected by multiplex PCR. Among isolates from children, 25 serotypes, including the prevalent types 6B (17.5%), 19F (15.6%), 23F (12.2%), and 6C (11.6%), were identified, revealing the PCV7 and PCV13 coverage rates as 48.2% and 60.3%, respectively, while serotype 3 was the most frequent (19.0%) among isolates from adults. Most of the pediatric isolates (96.8%) exhibited resistance to EM (minimum inhibitory concentration [MIC], \u22651\u2009\u03bcg\/ml), with a higher prevalence of\n                    <jats:italic toggle=\"yes\">erm(B)<\/jats:italic>\n                    (67.2%) than\n                    <jats:italic toggle=\"yes\">mef(A\/E)<\/jats:italic>\n                    (39.7%).\n                    <jats:italic toggle=\"yes\">erm(B)<\/jats:italic>\n                    was associated with high-level EM resistance (MIC, \u2265128\u2009\u03bcg\/ml) and distributed at high detection rates to major serotypes 23F (85.2%) and 6B (85.1%), as well as minor serotypes 3, 10A, 14, 15B, 15C, 19A, and 23A (&gt;90%). While penicillin-resistant\n                    <jats:italic toggle=\"yes\">S. pneumoniae<\/jats:italic>\n                    (PRSP) (penicillin G-MIC, 2\u20133\u2009\u03bcg\/ml) was detected in 7.8% of isolates from children, the most common PBP gene genotype was gPRSP (three altered genes\n                    <jats:italic toggle=\"yes\">pbp1a<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">2x<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">2b<\/jats:italic>\n                    ; 38.3%), which was detected at higher rates (&gt;60%) in the dominant serotypes 23F, 6B, and 19F, and minor serotypes 6D and 15A. Dominant serotypes in the\n                    <jats:italic toggle=\"yes\">S. pneumoniae<\/jats:italic>\n                    isolates were generally similar to those reported for invasive strains, despite lower coverage rates by PCV7\/13. The importance of further surveillance on incidence and drug resistance in the post-PCV7 period was suggested for non-PCV7\/13 serotypes 6C, 6D, 10A, 15A, 15B, 15C, 23A, and 35B.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2013.0196","type":"journal-article","created":{"date-parts":[[2014,4,25]],"date-time":"2014-04-25T14:49:23Z","timestamp":1398437363000},"page":"456-465","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Serotype Distribution and Susceptibility to Penicillin and Erythromycin Among Noninvasive or Colonization Isolates of\n                    <i>Streptococcus pneumoniae<\/i>\n                    in Northern Japan: A Cross-Sectional Study in the Pre-PCV7 Routine Immunization Period"],"prefix":"10.1177","volume":"20","author":[{"given":"Mitsuyo","family":"Kawaguchiya","sequence":"first","affiliation":[{"name":"Sapporo Medical University School of Medicine","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriko","family":"Urushibara","sequence":"additional","affiliation":[{"name":"Sapporo Medical University School of Medicine","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Souvik","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Sapporo Medical University School of Medicine","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamu","family":"Kuwahara","sequence":"additional","affiliation":[{"name":"Sapporo Clinical Laboratory, Inc.","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeo","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Sapporo Clinical Laboratory, Inc.","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Ito","sequence":"additional","affiliation":[{"name":"Sapporo Clinical Laboratory, Inc.","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Kudo","sequence":"additional","affiliation":[{"name":"Sapporo Clinical Laboratory, Inc.","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobumichi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Sapporo Medical University School of Medicine","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2014,10]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"1","article-title":"Preventing pneumococcal disease among infants and young children. 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