Serotypes and clones causing invasive pneumococcal disease before the use of new conjugate vaccines in Catalonia, Spain Carmen Mu ~ noz-Almagro a, *, Pilar Ciruela b , Cristina Esteva a , Francesc Marco c , Marian Navarro d , Rosa Bartolome e , Goretti Sauca f , CarmenGalle´s g , Montse Morta h , Frederic Ballester i , Xavier Raga j , Laura Selva a , for the Catalan study group of invasive pneumococcal disease a Molecular Microbiology Department, Hospital Sant Joan de Deu, P  Sant Joan de Deu 2, 08950 Esplugues, Barcelona, Spain b General Directorate of Public Health, Government of Catalonia, C/Roc Boronat 81- 95, 08005 Barcelona, Spain c Microbiology Department Hospital Clinic-IDIBAPS. C/Villarroel 170, 08036 Barcelona, Spain d Microbiology Department, Hospital de Vic, C/Francesc Pla 1, 08500 Vic, Spain e Microbiology Department, Hospital Vall d’Hebron, Passeig Vall d’Hebron 119 e 129, 08035 Barcelona, Spain f Microbiology Department, Hospital de Matar  o, CTRA. Cirera S/N, 08304 Matar  o, Spain g Microbiology Department, Hospital Sant Jaume, C/Sant Jaume 209, 08370 Calella, Spain h Microbiology Department, Althaia Xarxa Asistencial, C/Dr. Joan Soler 1-3, 08243 Manresa, Spain i Microbiology Department, Hospital Sant Joan, C/Sant Joan S/N, 43201 Reus, Spain j Microbiology Department, Hospital Sant Pau i Santa Tecla, C/Rbla. Vella 14, 43003 Tarragona, Spain Accepted 3 June 2011 Available online 12 June 2011 KEYWORDS Clones; Empyema; Pneumococcal vaccine; Pneumonia; Serotypes; Streptococcus pneumoniae Summary Objectives: The objective of this study was to learn the serotype distribution and clonal composition of pneumococci causing invasive pneumococcal disease (IPD) in children and adults in Spain before the introduction of new 10-valent (PCV10) and 13-valent (PCV13) conjugate vaccines. Methods: This is a 1-year prospective study including all patients with culture-proved IPD ad- mitted to 30 medical centers in Catalonia, Spain, during the year 2009. Results: A total of 614 episodes of IPD occurred in 612 patients. The rates of IPD were highest in children aged <24 months and adults >64 years (64.5 and 44.7 per 100,000 population). The burden of disease was mainly due to pneumonia in all age ranges. 609 of 614 strains were ser- otyped and 47 different serotypes were found. Among the 609 IPD cases with known serotype, 12.2% were caused by PCV7 serotypes, 51% by PCV10 serotypes, and 71.7% by PCV13 serotypes. 608 of 614 isolates were characterized by MLST. The main clonal types detected were ST306, CC191 and CC230. * Corresponding author. Tel.: þ34 932805569; fax: þ34 932803626. E-mail address: cma@hsjdbcn.org (C. Mu~ noz-Almagro). 0163-4453/$36 ª 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jinf.2011.06.002 www.elsevierhealth.com/journals/jinf Journal of Infection (2011) 63, 151e162