{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:44:54Z","timestamp":1787939094787,"version":"build-2784847793"},"reference-count":71,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004829","name":"Department of Science and Technology of Sichuan Province","doi-asserted-by":"publisher","award":["2020YFS0100, 2020YFS0103"],"award-info":[{"award-number":["2020YFS0100, 2020YFS0103"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009564","name":"Health and Family Planning Commission of Sichuan Province","doi-asserted-by":"publisher","award":["19PJ227, 17ZD005"],"award-info":[{"award-number":["19PJ227, 17ZD005"]}],"id":[{"id":"10.13039\/501100009564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010822","name":"Chengdu Science and Technology Bureau","doi-asserted-by":"publisher","award":["2019-YF05-01178-SN"],"award-info":[{"award-number":["2019-YF05-01178-SN"]}],"id":[{"id":"10.13039\/501100010822","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["SCU2019C4198"],"award-info":[{"award-number":["SCU2019C4198"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010828","name":"Department of Education of Guizhou Province","doi-asserted-by":"publisher","award":["QiankeheKYzi [2020]019"],"award-info":[{"award-number":["QiankeheKYzi [2020]019"]}],"id":[{"id":"10.13039\/501100010828","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018555","name":"Science and Technology Program of Guizhou Province","doi-asserted-by":"publisher","award":["Qiankehezhicheng [2020]4Y201"],"award-info":[{"award-number":["Qiankehezhicheng [2020]4Y201"]}],"id":[{"id":"10.13039\/501100018555","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Streptococcus pneumoniae<\/jats:italic> is an important pathogen causing high morbidity and high mortality in children and undergoes frequent recombination for capsule switching to neutralize the 13-valent pneumococcal conjugate vaccine (PCV13). This study aimed to investigate the prevalence, and molecular characteristics including serotypes and antibiotic susceptibility of <jats:italic>S. pneumoniae<\/jats:italic> isolated from children living in Southwest China from 2017 to 2019 to facilitate the selection of effective vaccine formulations and appropriate antibiotic treatment regimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was conducted at West China Second University Hospital (Chengdu, Sichuan Province, China), Zunyi Medical University Third Affiliated Hospital\/First People\u2019s Hospital of Zunyi (Zunyi, Guizhou Province, China) and Chengdu Jinjiang District Maternal and Child Healthcare Hospital (Chengdu, Sichuan Province, China). Demographic and clinical characteristics of children infected with <jats:italic>S. pneumoniae<\/jats:italic> were collected and analysed. Next-generation sequencing and sequence analysis were used to determine the serotypes, sequence types, antibiotic resistance and potential protein vaccine target genes of the pneumococcal isolates. The coverage rate provided by PCV13 was estimated by calculating the percentage of the specific serotypes that were specifically the PCV13-included serotypes. Antimicrobial susceptibility was determined by the microdilution broth method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The most prevalent pneumococcal serotypes were 19F (25.8%), 19A (14.1%), 6B (12.5%), 6A (9.4%) and 14 (7.8%). The predominant STs were ST271 (23.3%), ST320 (15.5%) and ST90 (8.6%), dominated by the clonal complex Taiwan<jats:sup>19F<\/jats:sup>-14 (39.1%). The\u00a0coverage rate of PCV13 was 77.3% in all the isolates, with relatively higher values in invasive isolates (86.4%). Over the decade, the rates of resistance to penicillin, amoxicillin and cefotaxime were 5.6%, 5.3% and 5.1%, respectively, with significantly higher values in invasive isolates (22.4%, 14.9% and 11.9%). Almost all the isolates were resistant to erythromycin (99.1%) and clindamycin (95.9%). All isolates carried virulence-related genes, including <jats:italic>ply, psaA, piaA, piuA, phtE, nanA, pepO, danJ, pvaA, clpP, pcsB, stkP, potD<\/jats:italic>, and <jats:italic>strH<\/jats:italic>. The carriage of virulence and resistance genes varied among serotypes and clades, with serotype 19F\/ST271 showing higher resistance to antibiotics and being more likely to carry pilus genes and other virulence genes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These data provide valuable information for the understanding of pneumococcal pathogenesis, antimicrobial resistance and the development of protein-based vaccines against pneumococcal infection.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2021.726740","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T05:40:22Z","timestamp":1635831622000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":34,"title":["Molecular Characterization Based on Whole-Genome Sequencing of Streptococcus pneumoniae in Children Living in Southwest China During 2017-2019"],"prefix":"10.3389","volume":"11","author":[{"given":"Ziyi","family":"Yan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yali","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaocui","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shikun","family":"Lei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Tong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meijing","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaifeng","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongmei","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0030787","article-title":"The Prevalence and Risk Factors for Pneumococcal Colonization of the Nasopharynx Among Children in Kilifi District, Kenya","volume":"7","author":"Abdullahi","year":"2012","journal-title":"PloS One"},{"key":"B2","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1128\/IAI.69.2.949-958.2001","article-title":"Identification and Characterization of a Novel Family of Pneumococcal Proteins That are Protective Against Sepsis","volume":"69","author":"Adamou","year":"2001","journal-title":"Infection Immun."},{"key":"B3","doi-asserted-by":"publisher","first-page":"6292","DOI":"10.1016\/j.vaccine.2016.10.061","article-title":"In Vivo Screen of Genetically Conserved Streptococcus Pneumoniae Proteins for Protective Immunogenicity","volume":"34","author":"Anderson","year":"2016","journal-title":"Vaccine"},{"key":"B4","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.ijid.2018.12.009","article-title":"Pneumococcal Serotype Distribution and Antibiotic Susceptibility in Malaysia: A Four-Year Stud","volume":"80","author":"Arushothy","year":"2019","journal-title":"Int. J. Infect. Dis."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0177113","article-title":"Serotype Distribution of Streptococcus Pneumoniae Causing Invasive Disease in Children in the Post-PCV Era: A Systematic Review and Meta-Analysis","volume":"12","author":"Balsells","year":"2017","journal-title":"PloS One"},{"key":"B6","doi-asserted-by":"publisher","first-page":"6702","DOI":"10.1128\/IAI.69.11.6702-6706.2001","article-title":"Immunization With Components of Two Iron Uptake ABC Transporters Protects Mice Against Systemic Streptococcus Pneumoniae Infection","volume":"69","author":"Brown","year":"2001","journal-title":"Infection Immun."},{"key":"B7","doi-asserted-by":"publisher","first-page":"3318","DOI":"10.1128\/JCM.01222-15","article-title":"Capsule Switching and Antimicrobial Resistance Acquired During Repeated Streptococcus Pneumoniae Pneumonia Episodes","volume":"53","author":"Chang","year":"2015","journal-title":"J. Clin. Microbiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"D694","DOI":"10.1093\/nar\/gkv1239","article-title":"VFDB 2016: Hierarchical and Refined Dataset for Big Data Analysis\u201310 Years on","volume":"44","author":"Chen","year":"2016","journal-title":"Nucleic Acids Res."},{"key":"B9","doi-asserted-by":"publisher","first-page":"7744","DOI":"10.1016\/j.vaccine.2018.05.026","article-title":"The Changing Epidemiology of Invasive Pneumococcal Disease After PCV13 Vaccination in a Country With Intermediate Vaccination Coverage","volume":"36","author":"Ciruela","year":"2018","journal-title":"Vaccine"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2108","DOI":"10.1128\/IAI.01125-09","article-title":"Three Surface Exoglycosidases From Streptococcus Pneumoniae, NanA, BgaA, and StrH, Promote Resistance to Opsonophagocytic Killing by Human Neutrophils","volume":"78","author":"Dalia","year":"2010","journal-title":"Infection Immun."},{"key":"B11","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1111\/j.1365-2249.2006.03047.x","article-title":"Pneumococcal 6-Phosphogluconate-Dehydrogenase, a Putative Adhesin, Induces Protective Immune Response in Mice","volume":"144","author":"Daniely","year":"2006","journal-title":"Clin. Exp. Immunol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.jbiotec.2016.12.022","article-title":"Application of Next Generation Sequencing in Clinical Microbiology and Infection Prevention","volume":"243","author":"Deurenberg","year":"2017","journal-title":"J. Biotechnol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.ram.2018.10.002","article-title":"Clinical and Microbiological Characteristics of Community-Acquired Pneumonia Associated With Streptococcus Pneumoniae in Adult Patients in Mexico","volume":"51","author":"Echaniz-Aviles","year":"2019","journal-title":"Rev. Argent. Microbiologia"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1518","DOI":"10.1128\/JB.186.5.1518-1530.2004","article-title":"eBURST: Inferring Patterns of Evolutionary Descent Among Clusters of Related Bacterial Genotypes From Multilocus Sequence Typing Data","volume":"186","author":"Feil","year":"2004","journal-title":"J.\u00a0Bacteriology"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00483-19","article-title":"Validating the AMRFinder Tool and Resistance Gene Database by Using Antimicrobial Resistance Genotype-Phenotype Correlations in a Collection of Isolates","volume":"63","author":"Feldgarden","year":"2019","journal-title":"Antimicrob. Agents Chemother."},{"key":"B16","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1186\/1471-2105-13-87","article-title":"PHYLOViZ: Phylogenetic Inference and Data Visualization for Sequence Based Typing Methods","volume":"13","author":"Francisco","year":"2012","journal-title":"BMC Bioinf."},{"key":"B17","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1084\/jem.20071168","article-title":"Discovery of a Novel Class of Highly Conserved Vaccine Antigens Using Genomic Scale Antigenic Fingerprinting of Pneumococcus With Human Antibodies","volume":"205","author":"Giefing","year":"2008","journal-title":"J. Exp. Med."},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2017.e00291","article-title":"Self-Assembled Particulate PsaA as Vaccine Against Infection","volume":"3","author":"Gonz\u00e1lez-Miro","year":"2017","journal-title":"Heliyon"},{"key":"B19","doi-asserted-by":"publisher","first-page":"5690","DOI":"10.1128\/IAI.68.10.5690-5695.2000","article-title":"Role of Novel Choline Binding Proteins in Virulence of Streptococcus Pneumoniae","volume":"68","author":"Gosink","year":"2000","journal-title":"Infection Immun."},{"key":"B20","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1128\/IAI.73.2.981-989.2005","article-title":"PppA, a Surface-Exposed Protein of Streptococcus Pneumoniae, Elicits Cross-Reactive Antibodies That Reduce Colonization in a Murine Intranasal Immunization and Challenge Model","volume":"73","author":"Green","year":"2005","journal-title":"Infection Immun."},{"key":"B21","doi-asserted-by":"publisher","first-page":"395","DOI":"10.2217\/fmb.12.2","article-title":"Molecular Mechanisms of \u03b2-Lactam Resistance in Streptococcus Pneumoniae","volume":"7","author":"Hakenbeck","year":"2012","journal-title":"Future Microbiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"3159","DOI":"10.1016\/j.vaccine.2019.04.085","article-title":"Serotype Distribution of Disease-Causing Streptococcus Pneumoniae in Thailand: A Systematic Review","volume":"37","author":"Hocknell","year":"2019","journal-title":"Vaccine"},{"key":"B23","doi-asserted-by":"publisher","first-page":"4040","DOI":"10.1128\/AAC.00094-15","article-title":"Genetic Analyses of Penicillin Binding Protein Determinants in Multidrug-Resistant Streptococcus Pneumoniae Serogroup 19 CC320\/271 Clone With High-Level Resistance to Third-Generation Cephalosporins","volume":"59","author":"Ip","year":"2015","journal-title":"Antimicrobial Agents Chemotherapy"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000348","article-title":"Systematic Evaluation of Serotypes Causing Invasive Pneumococcal Disease Among Children Under Five: The Pneumococcal Global Serotype Project","volume":"7","author":"Johnson","year":"2010","journal-title":"PloS Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1186\/1471-2105-11-595","article-title":"BIGSdb: Scalable Analysis of Bacterial Genome Variation at the Population Level","volume":"11","author":"Jolley","year":"2010","journal-title":"BMC Bioinf."},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.2477","article-title":"Whole Genome Sequencing of Streptococcus Pneumoniae: Development, Evaluation and Verification of Targets for Serogroup and Serotype Prediction Using an Automated Pipeline","volume":"4","author":"Kapatai","year":"2016","journal-title":"PeerJ"},{"key":"B27","doi-asserted-by":"publisher","first-page":"6065","DOI":"10.1016\/j.vaccine.2019.09.065","article-title":"Changes in Serotype Distribution and Antimicrobial Resistance of Streptococcus Pneumoniae Isolates From Adult Patients in Asia: Emergence of Drug-Resistant non-Vaccine Serotypes","volume":"38","author":"Kim","year":"2020","journal-title":"Vaccine"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1418","DOI":"10.1128\/AAC.05658-11","article-title":"Changing Trends in Antimicrobial Resistance and Serotypes of Streptococcus Pneumoniae Isolates in Asian Countries: An Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study","volume":"56","author":"Kim","year":"2012","journal-title":"Antimicrobial Agents chemotherapy"},{"key":"B29","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1111\/mmi.13312","article-title":"Highly Conserved Nucleotide Phosphatase Essential for Membrane Lipid Homeostasis in Streptococcus Pneumoniae","volume":"101","author":"Kuipers","year":"2016","journal-title":"Mol. Microbiol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"5646","DOI":"10.1128\/IAI.72.10.5646-5653.2004","article-title":"The ClpP Protease of Streptococcus Pneumoniae Modulates Virulence Gene Expression and Protects Against Fatal Pneumococcal Challenge","volume":"72","author":"Kwon","year":"2004","journal-title":"Infection Immun."},{"key":"B31","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1016\/j.vaccine.2017.12.063","article-title":"Phenotypic and Molecular Characterization of Streptococcus Pneumoniae in Pre-Conjugate Vaccine Era: A Chinese Hospital-Based Retrospective Study","volume":"36","author":"Li","year":"2018","journal-title":"Vaccine"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2019.00407","article-title":"Serotype Distribution, Antimicrobial Susceptibility, and Multilocus Sequencing Type (MLST) of From Adults of Three Hospitals in Shanghai, China","volume":"9","author":"Li","year":"2019","journal-title":"Front. Cell. infection Microbiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"132","DOI":"10.3390\/vaccines8010132","article-title":"Development of Next Generation Vaccines Conferring Broad Protection","volume":"8","author":"Masomian","year":"2020","journal-title":"Vaccines"},{"key":"B34","doi-asserted-by":"publisher","first-page":"3524","DOI":"10.1016\/j.vaccine.2020.03.030","article-title":"Molecular Characterization of Latin American Invasive Streptococcus Pneumoniae Serotype 19A Isolates","volume":"38","author":"Moreno","year":"2020","journal-title":"Vaccine"},{"key":"B35","doi-asserted-by":"publisher","first-page":"2537","DOI":"10.1093\/molbev\/msx173","article-title":"Pneumococcal Capsule Synthesis Locus Cps as Evolutionary Hotspot With Potential to Generate Novel Serotypes by Recombination","volume":"34","author":"Mostowy","year":"2017","journal-title":"Mol. Biol. Evol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/j.vaccine.2018.11.015","article-title":"Immunization With Pneumococcal Elongation Factor Tu Enhances Serotype-Independent Protection Against Streptococcus Pneumoniae Infection","volume":"37","author":"Nagai","year":"2019","journal-title":"Vaccine"},{"key":"B37","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":"B38","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1016\/S0140-6736(09)61204-6","article-title":"Burden of Disease Caused by Streptococcus Pneumoniae in Children Younger Than 5 Years: Global Estimates","volume":"374","author":"O'Brien","year":"2009","journal-title":"Lancet (London England)"},{"key":"B39","doi-asserted-by":"publisher","first-page":"4604","DOI":"10.1128\/IAI.68.8.4604-4610.2000","article-title":"Differential Protein Expression in Phenotypic Variants of Streptococcus Pneumoniae","volume":"68","author":"Overweg","year":"2000","journal-title":"Infection Immun."},{"key":"B40","doi-asserted-by":"publisher","first-page":"3691","DOI":"10.1093\/bioinformatics\/btv421","article-title":"Roary: Rapid Large-Scale Prokaryote Pan Genome Analysis","volume":"31","author":"Page","year":"2015","journal-title":"Bioinf. (Oxford England)"},{"key":"B41","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1128\/iai.40.2.548-552.1983","article-title":"Effect of Immunization With Pneumolysin on Survival Time of Mice Challenged With Streptococcus Pneumoniae","volume":"40","author":"Paton","year":"1983","journal-title":"Infection Immun."},{"key":"B42","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1136\/thoraxjnl-2019-213725","article-title":"Pneumococcal Serotype Trends, Surveillance and Risk Factors in UK Adult Pneumoni","volume":"75","author":"Pick","year":"2020","journal-title":"Thorax"},{"key":"B43","doi-asserted-by":"publisher","first-page":"e102","DOI":"10.1002\/cpbi.102","article-title":"Using SPAdes De Novo Assembler","volume":"70","author":"Prjibelski","year":"2020","journal-title":"Curr. Protoc. Bioinf."},{"key":"B44","doi-asserted-by":"publisher","first-page":"1074","DOI":"10.3201\/eid1907.121830","article-title":"Pneumococcal Serotypes Before and After Introduction of Conjugate Vaccines, United State","volume":"19","author":"Richter","year":"2013","journal-title":"Emerging Infect. Dis."},{"key":"B45","doi-asserted-by":"publisher","first-page":"2068","DOI":"10.1093\/bioinformatics\/btu153","article-title":"Prokka: Rapid Prokaryotic Genome Annotation","volume":"30","author":"Seemann","year":"2014","journal-title":"Bioinf. (Oxford England)"},{"key":"B46","doi-asserted-by":"publisher","first-page":"1312","DOI":"10.1093\/bioinformatics\/btu033","article-title":"RAxML Version 8: A Tool for Phylogenetic Analysis and Post-Analysis of Large Phylogenies","volume":"30","author":"Stamatakis","year":"2014","journal-title":"Bioinf. (Oxford England)"},{"key":"B47","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/j.jinf.2020.07.035","article-title":"Streptococcus Pneumoniae Serotype Distribution and Antimicrobial Nonsusceptibility Trends Among Adults With Pneumonia in the United State 2009\u20132017","volume":"81","author":"Suaya","year":"2020","journal-title":"J. Infection"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.00686","article-title":"Subcutaneous Immunization With Fusion Protein DnaJ-\u0394A146Ply Without Additional Adjuvants Induces Both Humoral and Cellular Immunity Against Pneumococcal Infection Partially Depending on TLR4","volume":"8","author":"Su","year":"2017","journal-title":"Front. Immunol."},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0167803","article-title":"Determination of Characteristics of Erythromycin Resistant Streptococcus Pneumoniae With Preferred PCV Usage in Iran","volume":"11","author":"Talebi","year":"2016","journal-title":"PloS One"},{"key":"B50","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1006\/mpat.1996.0038","article-title":"Protection of Mice Against Fatal Pneumococcal Challenge by Immunization With Pneumococcal Surface Adhesin A (PsaA)","volume":"21","author":"Talkington","year":"1996","journal-title":"Microbial Pathogenesis"},{"key":"B51","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.jiac.2017.12.010","article-title":"Laboratory Surveillance of Antimicrobial Resistance and Multidrug Resistance Among Streptococcus Pneumoniae Isolated in the Kinki Region of Japa","volume":"24","author":"Toda","year":"2018","journal-title":"J. Infection Chemotherapy Off. J. Japan Soc. Chemotherapy"},{"key":"B52","doi-asserted-by":"publisher","first-page":"7775","DOI":"10.1128\/IAI.73.11.7775-7778.2005","article-title":"Immunization With Recombinant Streptococcus Pneumoniae Neuraminidase NanA Protects Chinchillas Against Nasopharyngeal Colonization","volume":"73","author":"Tong","year":"2005","journal-title":"Infection Immun."},{"key":"B53","doi-asserted-by":"publisher","first-page":"7176","DOI":"10.1128\/IAI.70.12.7176-7178.2002","article-title":"Peptidoglycan N-Acetylglucosamine Deacetylase, a Putative Virulence Factor in Streptococcus Pneumoniae","volume":"70","author":"Vollmer","year":"2002","journal-title":"Infection Immun."},{"key":"B54","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1186\/s12879-020-04998-5","article-title":"Epidemiological and Molecular Characterization of Streptococcus Pneumoniae Carriage Strains in Pre-School Children in Arkhangelsk, Northern European Russia, Prior to the Introduction of Conjugate Pneumococcal Vaccines","volume":"20","author":"Vorobieva S Jensen","year":"2020","journal-title":"BMC Infect. Dis."},{"key":"B55","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1038\/ismej.2008.93","article-title":"A Comparison of Homologous Recombination Rates in Bacteria and Archaea","volume":"3","author":"Vos","year":"2009","journal-title":"ISME J."},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000015942","article-title":"Antibiotic Resistance Profiles and Multidrug Resistance Patterns of Streptococcus Pneumoniae in Pediatrics: A Multicenter Retrospective Study in Mainland China","volume":"98","author":"Wang","year":"2019","journal-title":"Medicine"},{"key":"B57","doi-asserted-by":"publisher","first-page":"2135","DOI":"10.1002\/ppul.24877","article-title":"Molecular Characterization of Streptococcus Pneumoniae Isolated From Pediatric Patients in Shanghai, China","volume":"55","author":"Wang","year":"2020","journal-title":"Pediatr. Pulmonology"},{"key":"B58","doi-asserted-by":"publisher","first-page":"7858","DOI":"10.1016\/j.vaccine.2020.10.005","article-title":"Serotype Distribution of Streptococcus Pneumoniae Isolated From Children Hospitalized in Beijing Children's Hospita","volume":"38","author":"Wang","year":"2020","journal-title":"Vaccine"},{"key":"B59","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1128\/IAI.74.1.352-361.2006","article-title":"Involvement of potD in Streptococcus Pneumoniae Polyamine Transport and Pathogenesis","volume":"74","author":"Ware","year":"2006","journal-title":"Infection Immun."},{"key":"B60","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing M100, 31st Edition","author":"Weinstein","year":"2021"},{"key":"B61","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1038\/s41579-018-0001-8","article-title":"Streptococcus Pneumoniae: Transmission, Colonization and Invasion","volume":"16","author":"Weiser","year":"2018","journal-title":"Nat. Rev. Microbiol."},{"key":"B62","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.1128\/IAI.69.3.1593-1598.2001","article-title":"Use of a Whole Genome Approach to Identify Vaccine Molecules Affording Protection Against Streptococcus Pneumoniae Infection","volume":"69","author":"Wizemann","year":"2001","journal-title":"Infection Immun."},{"key":"B63","doi-asserted-by":"publisher","first-page":"737","DOI":"10.2217\/fmb-2015-0011","article-title":"Prevalence and Antibiotic Resistance of Commensal Streptococcus Pneumoniae in Nine European Countries","volume":"11","author":"Yahiaoui","year":"2016","journal-title":"Future Microbiol."},{"key":"B64","article-title":"In-House Sequence Database of S.pn Recombinant Protein Vaccine Target-Related Genes [Data Set]","volume-title":"Zenodo.","author":"Yan","year":"2021"},{"key":"B65","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/j.ijid.2020.10.017","article-title":"Serotype Distribution and Antimicrobial Susceptibility of Streptococcus Pneumoniae Associated With Invasive Pneumococcal Disease Among Adults in Japan","volume":"102","author":"Yanagihara","year":"2021","journal-title":"Int. J. Infect. Dis. IJID Off. Publ. Int. Soc. Infect. Dis."},{"key":"B66","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1016\/j.vaccine.2018.12.021","article-title":"Molecular Characterization of Streptococcus Pneumoniae in Children Living in Southwest China and Assessment of a Potential Protein Vaccine, Rpfba","volume":"37","author":"Yan","year":"2019","journal-title":"Vaccine"},{"key":"B67","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1146\/annurev.micro.62.081307.162944","article-title":"Capsules of Streptococcus Pneumoniae and Other Bacteria: Paradigms for Polysaccharide Biosynthesis and Regulation","volume":"65","author":"Yother","year":"2011","journal-title":"Annu. Rev. Microbiol."},{"key":"B68","doi-asserted-by":"publisher","first-page":"3324","DOI":"10.1038\/s41598-019-40088-6","article-title":"Epidemiological Characteristics of Nasopharyngeal Streptococcus Pneumoniae Strains Among Children With Pneumonia in Chongqing, China","volume":"9","author":"Yu","year":"2019","journal-title":"Sci. Rep."},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2016.00023","article-title":"Streptococcus Pneumoniae Endopeptidase O (PepO) Elicits a Strong Innate Immune Response in Mice via TLR2 and TLR4 Signaling Pathways","volume":"6","author":"Zhang","year":"2016","journal-title":"Front. Cell. Infection Microbiol."},{"key":"B70","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1016\/S1473-3099(20)30596-X","article-title":"Appropriateness of Antibiotic Prescriptions in Ambulatory Care in China: A Nationwide Descriptive Database Study","volume":"21","author":"Zhao","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"B71","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1007\/s10096-016-2582-3","article-title":"Molecular Characteristics of Penicillin-Binding Protein 2b, 2x and 1a Sequences in Streptococcus Pneumoniae Isolates Causing Invasive Diseases Among Children in Northeast China","volume":"35","author":"Zhou","year":"2016","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis. Off. Publ. Eur. Soc. Clin. Microbiol."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2021.726740\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T05:40:28Z","timestamp":1635831628000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2021.726740\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,2]]},"references-count":71,"alternative-id":["10.3389\/fcimb.2021.726740"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2021.726740","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,2]]},"article-number":"726740"}}