Volume 24, Number 11—November 2018
Research
Effects of Pneumococcal Conjugate Vaccine on Genotypic Penicillin Resistance and Serotype Changes, Japan, 2010–2017
Figure 4

Figure 4. Details of Streptococcus pneumoniae clonal complex (CC) 156 (n = 4,736), including 1,308 sequence types obtained from the multilocus sequence typing website (https://pubmlst.org/spneumoniae/). Data include those from this study (n = 359). STs of 6 genotypes for penicillin-resistant S. pneumoniae identified in NVT serotypes belonged to CC156. STs of serotypes 6C, 13, 23A, and 23B were derived from ST338 and ST172 (shown in red). Serotypes 6D and 35B belonged to ST90 and ST156, respectively. The Pneumococcal Molecular Epidemiology Network clone identified in CC156 is also shown (in green). The red line indicates evolution from ST156 to ST338: a, ST8055; b, ST8618; c, ST4542; d, ST171; e, ST361. NVT, nonvaccine serotype; PCV7, 7-valent pneumococcal conjugate vaccine; PCV13, 13-valent pneumococcal conjugate vaccine; PPSV23, 23-valent pneumococcal polysaccharide vaccine; ST, sequence type.