{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T20:17:22Z","timestamp":1770063442942,"version":"3.49.0"},"reference-count":46,"publisher":"Microbiology Society","issue":"4","license":[{"start":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T00:00:00Z","timestamp":1682035200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"crossref","award":["OPP1034556"],"award-info":[{"award-number":["OPP1034556"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","award":["098051"],"award-info":[{"award-number":["098051"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","award":["206194"],"award-info":[{"award-number":["206194"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,21]]},"abstract":"<jats:p>The introduction of pneumococcal conjugate vaccines (PCV7, PCV10, PCV13) around the world has proved successful in preventing invasive pneumococcal disease. However, immunization against <jats:italic>\n                     <jats:named-content content-type=\"species\">\n                        <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/doi.org\/10.1601\/nm.5677\" xlink:type=\"simple\">Streptococcus pneumoniae<\/jats:ext-link>\n                     <\/jats:named-content>\n                  <\/jats:italic> has led to serotype replacement by non-vaccine serotypes, including serotype 15A. Clonal complex 63 (CC63) is associated with many serotypes and has been reported in association with 15A after introduction of PCVs. A total of 865 CC63 isolates were included in this study, from the USA (<jats:italic>n<\/jats:italic>=391) and a global collection (<jats:italic>n<\/jats:italic>=474) from 1998\u20132019 and 1995\u20132018, respectively. We analysed the genomic sequences to identify serotypes and penicillin-binding protein (PBP) genes 1A, 2B and 2X, and other resistance determinants, to predict minimum inhibitory concentrations (MICs) against penicillin, erythromycin, clindamycin, co-trimoxazole and tetracycline. We conducted phylogenetic and spatiotemporal analyses to understand the evolutionary history of the 15A-CC63 sub-lineage. Overall, most (89.5\u200a%, <jats:italic>n<\/jats:italic>=247) pre-PCV isolates in the CC63 cluster belonged to serotype 14, with 15A representing 6.5\u200a% of isolates. Conversely, serotype 14 isolates represented 28.2\u200a% of post-PCV CC63 isolates (<jats:italic>n<\/jats:italic>=618), whilst serotype 15A isolates represented 65.4\u200a%. Dating of the CC63 lineage determined the most recent common ancestor emerged in the 1980s, suggesting the 15A-CC63 sub-lineage emerged from its closest serotype 14 ancestor prior to the development of pneumococcal vaccines. This sub-lineage was predominant in the USA, Israel and China. Multidrug resistance (to three or more drug classes) was widespread among isolates in this sub-lineage. We show that the CC63 lineage is globally distributed and most of the isolates are penicillin non-susceptible, and thus should be monitored.<\/jats:p>","DOI":"10.1099\/mgen.0.000998","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T17:17:55Z","timestamp":1682097475000},"source":"Crossref","is-referenced-by-count":7,"title":["A global genomic perspective on the multidrug-resistant Streptococcus pneumoniae 15A-CC63 sub-lineage following pneumococcal conjugate vaccine introduction"],"prefix":"10.1099","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5096-392X","authenticated-orcid":false,"given":"Paulina A.","family":"Hawkins","sequence":"first","affiliation":[{"name":"Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, 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