“…In southern China in 2011, the serotypes 4, 5, 13, 15, and 2 predominated ( Zhang et al, 2011 ). Other three studies in China indicated the documented serotypes were 4, 5, 14, 13 in 2015 and 5, 4, 7, 13 in 2016 and 4, 5, 7, 1 in 2017 ( Chen et al, 2015 ; Ma et al, 2016 ; Wang et al, 2017 ). In addition to these studies, high NT isolation rates (10–40%) were reported in all previously described studies, which maybe become a dominant serotype in Germany, USA/Canada, Denmark and Brazil ( Angen, Svensmark & Mittal, 2004 ; Kielstein & Rapp-Gabrielson, 1992 ; Rapp-Gabrielson & Gabrielson, 1992 ), and even became the most serotype in Brazil ( Macedo et al, 2011 ; Moreno et al, 2011 ).…”