A retrospective analysis of serotypes and groups of Streptococcus pneumoniae recovered over a 12-year period (1973-1984) from pediatric and adult patients ( > 18 years old) at a large urban hospital is presented. The majority of the 3,302 pneumococcal isolates (2,807, or 85%) were from the respiratory tract, 68% were from adults, and 30% were from children. Of the respiratory isolates from adults, the most common serotypes and groups recovered were, in decreasing order: 3, 19, 9, 23, 4, and 6; and from children, the most common were: 19, 3, 6, 23, 15, and 18. The remaining 15% (495) of the isolates were from patients with either meningitis and/or bacteremia, with 433 (87%) from adults and 62 (13%) from children. From these body sites, the most common types and groups were 4, 3, 8, 14, 9, and 19 from adults and 14, 6, 18, 19, 23, and 4 from children. Approximately 89% of these types and groups are represented in the 23-valent vaccine. Although other investigators have reported corresponding arrays of isolates represented in the vaccine, the contrasts in serotypes underscore regional differences which may be germane to future vaccine formulations.
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Steinberg et al. (1988) studied this question.