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Non-vaccine Pneumococcal Serotypes Among Children with Invasive Pneumococcal Disease. OBJECTIVE: To report the percentage of non-vaccine pneumococcal serotypes and their antibiotic susceptibility pattern in children with invasive peumococcal disease. METHODS: Invasive pneumococcal isolates of children <5 years during January 2007 to December 2016 were serotyped by a co-agglutination reaction and sequential multiplex polymerase chain reaction. RESULTS: Among the total 170 S. pneumoniae invasive isolates, 54 (31.8%) and 44 (25.9%) were the serotypes, which are not included in current 10-valent or 13-valent vaccines, respectively. Very low resistance was observed against penicillin (4.5%) and all isolates were susceptible to cefotaxime. CONCLUSIONS: One-fourth to one-third of the S. pneumoniae serotypes in under-five children with invasive pneumococcal disease are not covered by existing pneumococcal vaccines in India.