{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T12:49:37Z","timestamp":1762865377978},"reference-count":45,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2008,3,1]],"date-time":"2008-03-01T00:00:00Z","timestamp":1204329600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2008,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The serotypes and susceptibilities to penicillin, macrolides, and clindamycin of 1,655 invasive isolates of\n            <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n            recovered between 1979 and 2004 were determined. A precipitous decrease of 61% in the number of isolates was found following 2000, the year of 7-valent protein-conjugated pneumococcal vaccine (PCV7) introduction (139 versus 55 per 2-year period prior to versus after 2000;\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001). This decrease was 84% in children &lt;5 years old (80 versus 13 per 2-year period;\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001) and 18 to 23% in other age groups (\n            <jats:italic>P<\/jats:italic>\n            , not significant). PCV7 serotypes decreased by 76% overall (103 versus 25 per 2-year period;\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001) and by 92% in children &lt;5 years old (65 versus 5 per 2-year period;\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001), with significant decreases in six of the seven PCV serotypes. Other serotypes, except for type 19A, decreased from 32 to 22 per 2-year period, while type 19A increased from 4 to 8 per 2-year period, although none of these changes reached significance. Drug resistance emerged slowly, with the first penicillin-intermediate strain isolated in 1980 and the first macrolide\/lincosamide-resistant strain isolated in 1984. The first penicillin-resistant strain was isolated in 1993. Resistance increased steadily thereafter until 2003-2004, when 51.1% of isolates were penicillin nonsusceptible and 53.3% were macrolide resistant. Clindamycin resistance remained low until 2003-2004, when 26.7% of strains were resistant; this was associated with the emergence of multidrug-resistant type 19A strains. This study documents the emergence of resistance over a quarter century among invasive pneumococci in the Cleveland area, as well as the reduction in disease caused by PCV7 serotypes following the introduction of PCV7 in 2000.\n          <\/jats:p>","DOI":"10.1128\/jcm.02321-07","type":"journal-article","created":{"date-parts":[[2008,1,31]],"date-time":"2008-01-31T02:04:48Z","timestamp":1201745088000},"page":"982-990","update-policy":"http:\/\/dx.doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":60,"title":["Changes in Serotypes and Antimicrobial Susceptibility of Invasive\n            <i>Streptococcus pneumoniae<\/i>\n            Strains in Cleveland: a Quarter Century of Experience"],"prefix":"10.1128","volume":"46","author":[{"given":"Michael R.","family":"Jacobs","sequence":"first","affiliation":[{"name":"Department of Pathology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caryn E.","family":"Good","sequence":"additional","affiliation":[{"name":"Department of Pathology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Beall","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saralee","family":"Bajaksouzian","sequence":"additional","affiliation":[{"name":"Department of Pathology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne R.","family":"Windau","sequence":"additional","affiliation":[{"name":"Department of Pathology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia G.","family":"Whitney","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","unstructured":"Epidemiology and Prevention of Vaccine-Preventable Diseases 2006"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.44.3.999-1017.2006"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000129685.04847.94"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200003000-00003"},{"key":"e_1_3_2_6_2","unstructured":"Immunization Coverage in the U.S. Centers for Disease Control and Prevention Atlanta GA 2007"},{"key":"e_1_3_2_7_2","first-page":"1","volume":"45","year":"1996","unstructured":"Centers for Disease Control and Prevention. 1996. 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