{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:20:09Z","timestamp":1789471209591,"version":"build-2803163510"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T00:00:00Z","timestamp":1616544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the characteristics of hosts, antimicrobial susceptibility, and molecular epidemiology of mucoid serotype 3 <jats:italic>Streptococcus pneumoniae<\/jats:italic> (<jats:italic>S. pneumoniae<\/jats:italic>) isolated from children in China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p><jats:italic>S. pneumoniae<\/jats:italic> isolates collected between January 2016 and December 2019 were analyzed. <jats:italic>S. pneumoniae<\/jats:italic> isolates with mucoid phenotype were selected visually, and serotype 3 isolates were confirmed by Quellung reaction. The antimicrobial susceptibility was measured by E-test. Multilocus sequence typing was used for clonal analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty (3.04%) isolates of mucoid serotype 3 <jats:italic>S. pneumoniae<\/jats:italic> were identified from 657 clinical isolates, and all of them were noninvasive strains. The mean age of the hosts was 5.69 \u00b1 3.28 years. The isolates included: 50.0% from the dissected tonsil or adenoid tissue in children with obstructive sleep apnea-hypopnea syndrome, 45.0% from sputum or bronchial lavages in children with pneumonia, and 5.0% from vaginal secretions of one patient with vulvovaginitis. All isolates were susceptible to penicillin, cefuroxime, ceftriaxone, meropenem, vancomycin, levofloxacin, trimethoprim\/sulfamethoxazole, and rifampin but resistant to erythromycin. Sequence type (ST)505 and its clonal complex (CC) were the main genotypes (95%). Antimicrobial susceptibility of ST180 and ST505 were compared, and the minimum inhibitory concentration (MIC) of ST505 isolates was significantly higher than that of ST180 for tetracycline, trimethoprim\/sulfamethoxazole, and meropenem.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mucoid serotype 3 <jats:italic>Streptococcus pneumoniae<\/jats:italic> can be isolated from various body parts, among which the respiratory system is the most common. It can cause noninvasive infection in children, and it has high susceptibility to a variety of antibiotics, especially \u03b2-lactams, but is resistant to macrolides. CC505 is the novel clonal complex found in China, which may be related to the worldwide mainstream clonal complex (CC180) but has its own biological characteristics.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2021.648040","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T15:14:34Z","timestamp":1685459674000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Properties of Mucoid Serotype 3 Streptococcus pneumoniae From Children in China"],"prefix":"10.3389","volume":"11","author":[{"given":"Ying","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Zhen","family":"Hua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Ping","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-Hu","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,3,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/jac\/dkf801","article-title":"Global antibiotic resistance in Streptococcus pneumoniae","volume":"50","author":"Adam","year":"2002","journal-title":"J. Antimicrob. Chemother."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e1007438","DOI":"10.1371\/journal.ppat.1007438","article-title":"Global emergence and population dynamics of divergent serotype 3 CC180 pneumococci","volume":"14","author":"Azarian","year":"2018","journal-title":"PloS Pathog."},{"key":"B3","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1128\/CVI.00591-15","article-title":"Capsular Polysaccharide (CPS) Release by Serotype 3 Pneumococcal Strains Reduces the Protective Effect of Anti-Type 3 CPS Antibodies","volume":"23","author":"Choi","year":"2016","journal-title":"Clin. Vaccine Immunol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1093\/jac\/48.3.391","article-title":"Characterization of paired mucoid\/non-mucoid Pseudomonas aeruginosa isolates from Danish cystic fibrosis patients: antibiotic resistance, beta-lactamase activity and RiboPrinting","volume":"48","author":"Ciofu","year":"2001","journal-title":"J. Antimicrob. Chemother."},{"key":"B5","doi-asserted-by":"publisher","first-page":"333","DOI":"10.5152\/iao.2017.4203","article-title":"The Adenoid Microbiome in Recurrent Acute Otitis Media and Obstructive Sleep Apnea","volume":"13","author":"Dirain","year":"2017","journal-title":"J. Int. Adv. Otol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"166","DOI":"10.6084\/m9.figshare.14230388.v1","article-title":"Streptococcus pneumoniae serogroups and colony morphology: a look back","volume":"53","author":"Dunne","year":"2010","journal-title":"P. N. G. Med. J."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01354-18","article-title":"Streptococcus pneumoniae Serotype 3 in Mexico, (1994 to 2017): Decrease of the Unusual Clonal Complex 4909 Lineage following PCV13 Introduction","volume":"57","author":"Echaniz-Aviles","year":"2019","journal-title":"J. Clin. Microbiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1186\/s12887-019-1722-1","article-title":"Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae causing invasive diseases in China: a meta-analysis","volume":"19","author":"Fu","year":"2019","journal-title":"BMC Pediatr."},{"key":"B9","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1016\/j.vaccine.2019.10.056","article-title":"Increase in Streptococcus pneumoniae serotype 3 associated parapneumonic pleural effusion\/empyema after the introduction of PCV13 in Germany","volume":"38","author":"Goettler","year":"2020","journal-title":"Vaccine"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e51208","DOI":"10.3791\/51208","article-title":"Capsular serotyping of Streptococcus pneumoniae using the Quellung reaction","author":"Habib","year":"2014","journal-title":"J. Vis. Exp."},{"key":"B11","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1080\/21645515.2015.1118593","article-title":"Interim results of an ecological experiment - Conjugate vaccination against the pneumococcus and serotype replacement","volume":"12","author":"Hausdorff","year":"2016","journal-title":"Hum. Vaccin. Immunother."},{"key":"B12","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1099\/jmm.0.028803-0","article-title":"Death or survival from invasive pneumococcal disease in Scotland: associations with serogroups and multilocus sequence types","volume":"60","author":"Inverarity","year":"2011","journal-title":"J. Med. Microbiol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.idc.2017.11.002","article-title":"Pediatric Community-Acquired Pneumonia in the United States: Changing Epidemiology, Diagnostic and Therapeutic Challenges, and Areas for Future Research","volume":"32","author":"Katz","year":"2018","journal-title":"Infect. Dis. Clin. North Am."},{"key":"B14","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/j.jiac.2013.10.010","article-title":"Contradiction between in vitro and clinical outcome: intravenous followed by oral azithromycin therapy demonstrated clinical efficacy in macrolide-resistant pneumococcal pneumonia","volume":"20","author":"Kohno","year":"2014","journal-title":"J. Infect. Chemother."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1870","DOI":"10.1093\/molbev\/msw054","article-title":"MEGA7: Molecular Evolutionary Genetics Analysis Version 7.0 for Bigger Datasets","volume":"33","author":"Kumar","year":"2016","journal-title":"Mol. Biol. Evol."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz1164","article-title":"Dose-specific effectiveness of 7- and 13-valent pneumococcal conjugate vaccines against vaccine-serotype Streptococcus pneumoniae colonization in children","volume":"71","author":"Lewnard","year":"2019","journal-title":"Clin. Infect. Dis"},{"key":"B17","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1016\/j.jpag.2017.06.002","article-title":"Epidemiological Features and Antibiotic Resistance Patterns of Haemophilus influenzae Originating from Respiratory Tract and Vaginal Specimens in Pediatric Patients","volume":"30","author":"Li","year":"2017","journal-title":"J. Pediatr. Adolesc. Gynecol."},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2019.00407","article-title":"Serotype Distribution, Antimicrobial Susceptibility, and Multilocus Sequencing Type (MLST) of Streptococcus pneumoniae From Adults of Three Hospitals in Shanghai, China","volume":"9","author":"Li","year":"2019","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.GPP3-0004-2018","article-title":"Streptococcus pneumoniae: Invasion and Inflammation","volume":"7","author":"Loughran","year":"2019","journal-title":"Microbiol. Spectr."},{"key":"B20","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1080\/14760584.2020.1750377","article-title":"Residual colonization by vaccine serotypes in rural South Africa four years following initiation of pneumococcal conjugate vaccine immunization","volume":"19","author":"Madhi","year":"2020","journal-title":"Expert Rev. Vaccines"},{"key":"B21","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.vaccine.2015.11.015","article-title":"Serotypes, antimicrobial susceptibility, and molecular epidemiology of invasive and non-invasive Streptococcus pneumoniae isolates in paediatric patients after the introduction of 13-valent conjugate vaccine in a nationwide surveillance study conducted in Japan in 2012-2014","volume":"34","author":"Nakano","year":"2016","journal-title":"Vaccine"},{"key":"B22","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1080\/21645515.2015.1075678","article-title":"Theory and strategy for Pneumococcal vaccines in the elderly","volume":"12","author":"Namkoong","year":"2016","journal-title":"Hum. Vaccin. Immunother."},{"key":"B23","doi-asserted-by":"publisher","first-page":"410","DOI":"10.3343\/alm.2015.35.4.410","article-title":"Characterization of Mucoid and Non-Mucoid Streptococcus pneumoniae Isolated From Outpatients","volume":"35","author":"Ogihara","year":"2015","journal-title":"Ann. Lab. Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"6126","DOI":"10.1016\/j.vaccine.2016.10.050","article-title":"Pneumococcal conjugate vaccine failure in children: A systematic review of the literature","volume":"34","author":"Oligbu","year":"2016","journal-title":"Vaccine"},{"key":"B25","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1097\/INF.0b013e31816fca86","article-title":"An international serotype 3 clone causing pediatric noninvasive infections in Israel, Costa Rica, and Lithuania","volume":"27","author":"Porat","year":"2008","journal-title":"Pediatr. Infect. Dis. J."},{"key":"B26","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1093\/oxfordjournals.molbev.a040454","article-title":"The neighbor-joining method: a new method for reconstructing phylogenetic trees","volume":"4","author":"Saitou","year":"1987","journal-title":"Mol. Biol. Evol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"267","DOI":"10.2340\/00015555-0738","article-title":"Microbiological findings in prepubertal girls with vulvovaginitis","volume":"17","author":"Sikanic-Dugic","year":"2009","journal-title":"Acta Dermatovenerol. Croat."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.3201\/eid2407.180029","article-title":"Pediatric Complicated Pneumonia Caused by Streptococcus pneumoniae Serotype 3 in 13-Valent Pneumococcal Conjugate Vaccinees, Portugal 2010-2015","volume":"24","author":"Silva-Costa","year":"2018","journal-title":"Emerg. Infect. Dis."},{"key":"B29","doi-asserted-by":"publisher","first-page":"4696","DOI":"10.1128\/JCM.43.9.4696-4703.2005","article-title":"Properties of novel international drug-resistant pneumococcal clones identified in day-care centers of Lisbon, Portugal","volume":"43","author":"Sousa","year":"2005","journal-title":"J. Clin. Microbiol."},{"key":"B30","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1128\/9781555816728.ch20","article-title":"Streptococcus","volume-title":"Manual of clinical microbiology","author":"Spellberg","year":"2011"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e13077","DOI":"10.1111\/cmi.13077","article-title":"Emerging concepts in the pathogenesis of the Streptococcus pneumoniae: From nasopharyngeal colonizer to intracellular pathogen","volume":"21","author":"Subramanian","year":"2019","journal-title":"Cell Microbiol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s13104-016-2353-3","article-title":"Invasive pneumococcal disease caused by mucoid serotype 3 Streptococcus pneumoniae: a case report and literature review","volume":"10","author":"Sugimoto","year":"2017","journal-title":"BMC Res. Notes"},{"key":"B33","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.jiac.2020.09.014","article-title":"Molecular epidemiological characterization in mucoid-type Streptococcus pneumoniae isolates obtained from invasive pneumococcal disease patients in Japan","volume":"27","author":"Ubukata","year":"2020","journal-title":"J. Infect. Chemother"},{"key":"B34","doi-asserted-by":"publisher","first-page":"e744","DOI":"10.1016\/S2214-109X(18)30247-X","article-title":"Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: global, regional, and national estimates for 2000-15","volume":"6","author":"Wahl","year":"2018","journal-title":"Lancet Glob. Health"},{"key":"B35","article-title":"Clinical and Laboratory Standards Institute","volume-title":"CLSIM100ED28-2018","author":"Weinstein","year":"2018"}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2021.648040\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T15:14:40Z","timestamp":1685459680000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2021.648040\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,24]]},"references-count":35,"alternative-id":["10.3389\/fcimb.2021.648040"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2021.648040","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,24]]},"article-number":"648040"}}