Macrolide resistance in these latter isolates was determined by erm(B), encoding an rRNA methyltransferase and also compromising clindamycin whereas mefA solely compromises macrolides.28 Rises and falls in resistance among bloodstream S. pneumoniae across Europe from 2005 to 2019 were erratic.25 What is consistent is that the vaccination of children with conjugate vaccines reduced the incidence of invasive pneumococcal infection.6,26. This evidence concerns the gene ETV5 and pneumococcal infection.