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Pneumococcus was isolated as a mixed infection with Candida parapsilosis in one patient with endophthalmitis. Of Ribociclib in vivo 612 conjunctivitis episodes, 213 (34.8%) were caused by unencapsulated isolates (Table?1). The percentage of unencapsulated isolates was similar in the four study periods: 20/63 (31.7%, 95% CI: 20.2?43.2) in 1999�C2001, 39/117 (33.3%, 95% CI: 24.8?41.8) in 2002�C04, 90/242 (37.2%, 95% CI: 31.1?43.3) in 2005�C07, and 64/190 (33.7%; 95% CI: 27.0?40.4) in 2008�C10 (chi-square for trend, p 0.9). Among the 399 encapsulated isolates causing conjunctivitis, the most prevalent serotypes during the 12-year study were serotypes 19A (n?=?53, 8.7% of total 612 conjunctival pneumococci), 15B (n?=?30, 4.9%), 6A (n?=?27, 4.4%), Otenabant 19F (n?=?25, 4.1%), 23F (n?=?21, 3.4%) and 6B (n?=?17, 2.8%). Conjunctivitis caused by PCV7 serotypes decreased over time: 34.9% (22/63) in 1999�C2001, 19.7% (23/117) in 2002�C04, 13.6% (33/242) in 2005�C07 and 3.2% (6/190) in 2008�C10 (p for trend p?MI-773 order These two STs belonged to the clonal complex (CC) 941. Two STs (344 and 3097) were detected among pattern C isolates. ST3097 is a single-locus variant of ST344 and both belonged to CC344. Most isolates with pattern D (31/34) had 100% similarity and only one ST (ST448) was detected, which is the representative ST of CC448. CC941 (ST941, ST942) isolates predominated between 1999 and 2006, exceeding ST448 by a ratio of 3 to 1 during this period. Since 2007, CC941 almost disappeared, being displaced by ST448, which was the main clone among unencapsulated pneumococci causing ocular infections in the last 4?years of the study. CC344 (ST344 and ST3097) isolates were present in all four study periods, ST3097 being more prevalent than ST344.