ObjectiveTo explore clinical features and antimicrobial resistance of lower respiratory tract infection (LRTI) with Streptococcus pneumoniae (S. pneumoniae) isolated from children in Nanjing.MethodsClinical data of children with confirmed S. pneumoniae LRTI through sputum culture at a children’s hospital in Nanjing between July 2013 and June 2014 were analyzed retrospectively, S. pneumoniae strains were performed antimicrobial susceptibility testing through KB method and minimum inhibitory concentration (MIC) testing.ResultsAmong 197 children with S. pneumoniae infection, 72.59% were ＜3 years old, 63.96% occurred in autumn and winter， 57.87％ had elevated leukocyte count, cough and fever were the most common clinical symptoms, complications of digestive and circulatory system were also common. The resistance rates of S. pneumoniae to azithromycin, penicillin, and erythromycin were 94.92%, 92.98%, and 88.83% respectively; the sensitivity rates to vancomycin, chloramphenicol, meropenem, ceftriaxone, and ofloxacin were all ＞90%, vancomycin was up to 98.98%.ConclusionThe percentage of S. pneumoniae LRTI is high in children< 3 years old, most occur in autumn and winter, resistance rates to azithromycin, penicillin, and erythromycin are all high, antimicrobial agents should be selected for the treatment of infection according to antimicrobial susceptibility testing.use