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Most of the major antibiotic resistance determinants and resistance genes to penicillins, cephalosporins, macrolides, and tetracyclines, which are clinically important in Streptococcus pneumoniae, have been observed in pneumococci in other countries. The aim of this study was to characterize the genetic background of these antimicrobial resistance determinants in S. pneumoniae from bloodstream infections in African and Asian countries. Spontaneous isolates of S. pneumoniae from bloodstream infections collected at nine centers between January 2001 and December 2005 were included. Multilocus sequence typing of 7 housekeeping genes was performed, and the genetic background of penicillin-resistance genes (n = 43), cephalosporin-resistance genes (n = 88), macrolide-resistance genes (n = 33), tetracycline-resistance genes (n = 34), and multidrug-resistance genes (n = 8) was examined. A total of 381 isolates (8 centers), including 148 from Africa (13 centers) and 233 from Asia (25 centers), were available. All strains carried penicillin-resistance genes, and 97% of the isolates carried penicillin-binding protein (PBP) 2A. There was no predominance of any genetic background of the PBP2X. In most strains from Africa, efflux pump(s) mediated high-level resistance to erythromycin. The sequence types observed in Asia were not detected in Africa, and most strains (53%) in Africa belonged to type 156. In contrast, in Asia, sequence type 113 (ST113) was the most prevalent type (41%), followed by ST23, ST6, and ST81. We firstly characterized the resistance genes of S. pneumoniae collected from bloodstream infections in Africa and Asia and compared the genetic background of these antimicrobial resistance determinants in these regions. The prevalence of AR genes in S.
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