ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Antibiotic Resistance and New Antimicrobial drugs
Epidemiology,Changing Resistance Trends and Serotypes of Streptococcus pneumoniae in children in Chongqing, China, 2019–2024: A Multicenter Study
Provisionally accepted
- 1Children‘s Hospital of Chongqing Medical University, Chongqing, China
- 2Department of Clinical Laboratory, Dian Jiang Peoples Hospital of Chongqing, Chongqing , China, Chongqing, China
- 3Chongqing Jiulongpo District People's Hospital, Chongqing, China
- 4Chongqing Red Cross Hospital, Chongqing, China
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Objective: Aim to understand the clinical characteristics, changing resistance trends and the distribution of bacterial serotypes of Streptococcus pneumoniae in children in Chongqing area from 2019 to 2024. Method: Streptococcus pneumoniae epidemiology and strains were collected from multi-center laboratory, and antimicrobial susceptibility testing was performed in the research central laboratory of each study period from 2019–2024,the results were interpreted by the breakpoint criteria recommended by the Clinical and Laboratory Standards Institute (CLSI) M100-S34 guidelines from 2024.The capsular swelling test was used for serotyping of Streptococcus pneumoniae and to calculate the vaccine coverage rate. Result: 17,180 Streptococcus pneumoniae strains were isolated over six years in total, accounting for 17.2% of the total clinically isolated pathogenic bacteria and 45.9% of the Gram-positive bacteria, whose sample source type was principally isolated from respiratory tract specimens (97.9%), followed by blood specimens (1.1%).Streptococcus pneumoniae was mainly isolated from preschool stage, toddler stage and infancy, with isolation ratios of 32.5%, 30.5% and 25.9% respectivel,accounting for 88.8% of the total number of Streptococcus pneumoniae. The detection rates of penicillin-sensitive strains (PSSP), penicillin-mediated strains (PISP), and penicillin-resistant strains (PRSP) separately were 83.7%(14196/16964), 14.8%(2513/16964), and 1.5%(255/16964).The resistance rates of Trimethoprim/sulfamethoxazole, levoffoxacin , moxiffoxacin, tetracycline in non-IPD percentages were higher than IPD group, chloramphenicol and rifampin were lower however. The average annual detection of Streptococcus pneumoniae in post-COVID-19 decreased, except for chloramphenicol, the resistance rates of other antibacterial drugs were lower than those before pre-COVID-19 without exception.Except for 8 (1.3%) non-typed isolates, thirteen serotypes were identified for the remaining strains. The top four serotypes accounted for 61.8%, namely 19F (n= 207,34.5%), 19A (n= 61, 10.2%), 6B (n=59, 9.8%) and 23F (n= 44, 7.3%). PCV7 covered 388 strains (64.6%), PCV10 covered 440 strains (73.3%), and PCV13 covered 501 strains (83.5%). Conclusion: The resistance rate of S. pneumoniae to penicillin, trimethoprim /sulfamethoxazole, erythromycin, clindamycin, cefotaxime, cefepime show significant downward trends over these six years.Pneumococcal vaccine PCV-13 can effectively cover the main drug-resistant serotypes in China, which PCV 13 vaccine is recommended for the prevention of Streptococcus pneumoniae infection. The findings contribute to informed and clinical policy decisions for prevention and treatment.
Keywords: Children`, Epidemiology, Resistance rate, serotype, Streptococcus pneumoniae, Vaccine
Received: 06 Sep 2025; Accepted: 09 Dec 2025.
Copyright: © 2025 Zhao, Chunmei, Yu, Xiong, Xiang, Liu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaoqiang Li
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