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JAMA. 2007;298(22):2612-2614.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

MMWR. 2007;56:1077-1080

2 figures, 1 table omitted

Streptococcus pneumoniae (pneumococcus) is a leading cause of otitis, sinusitis, pneumonia, and meningitis worldwide. Treatment of the most serious type of pneumococcal infection, invasive pneumococcal disease (IPD),* is complicated by antimicrobial resistance. Widespread introduction in 2000 of heptavalent pneumococcal conjugate vaccine (PCV7) against serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F resulted in a decline in antimicrobial-nonsusceptible IPD in the United States^1-2, including in Massachusetts.³ However, development of antimicrobial resistance in serotypes not covered by PCV7 is a growing concern^{1, 4}. In Massachusetts during 2001-2006, IPD surveillance identified an increased number of cases in children caused by pneumococcal serotypes (most notably 19A) not covered by PCV7 and an associated increase in antimicrobial resistance among these isolates. This report examines these trends and clinical characteristics of Massachusetts patients with antimicrobial-nonsusceptible, non–PCV7-type IPD. The findings indicated that, despite increases in incidence of antimicrobial-nonsusceptible . . . [Full Text of this Article]

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