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Distribution of major clones of macrolide resistant invasive S. pneumoniae strains isolated from adult patients (1999 to 2007). Lettered brackets: a, significant decrease of CC81 in pre-PCV7 compared to late-PCV7 periods; b, significant increase of CC230 in pre-PCV7 compared to late-PCV7 periods; c, significant increase of ST717 in pre-PCV7 compared to late-PCV7 periods.
