1887

Abstract

Ninety-one consecutive pneumococcal isolates (primarily from sputum), recovered in Chongqing Southwest Hospital during a 12 month period in 2009–2010 from individuals of all ages with suspected cases of pneumococcal disease, were subjected to PCR-serotyping, Quellung reaction serotyping, antimicrobial-susceptibility testing and multilocus sequence typing (MLST). Although 20 different serotypes were observed, most isolates (69, 75.8 %) were of serotypes included in the pneumococcal 13-valent conjugate vaccine (PCV13), including 33 of the 46 (71.7 %) isolates recovered from individuals less than 5 years of age. The prevalent serotypes were 19F (34 %), 19A (9.9 %), 6B (9.9 %), 23F (7.7 %), 14 (6.6 %) and 6A (4.4 %). PCR-determined serotypes were in agreement with Quellung testing, with the exception of two serotype 33C isolates. Most or all isolates within each PCV13 serotype were represented by one genotype, with the globally disseminated MLST sequence types (STs) ST271, ST320, ST90 and ST81 each accounting for the highly resistant isolates within serotypes 19F, 19A, 6B and 23F, respectively. Sixty-six (72.5 %) isolates were resistant to combinations of β-lactam antibiotics (BLAs). A total of 63 of these 66 (95.5 %) BLA-resistant isolates were of serotypes included in PCV13; however, 3 serogroup 15 isolates were also BLA-resistant. Most isolates (88/91 = 96.7 %) were resistant to erythromycin and clindamycin. The majority of isolates were also resistant to tetracycline (76, 84 %) and to cotrimoxazole (67, 74 %). This work revealed that the majority of antimicrobial-resistant isolates (50/91 = 54.9 %) recovered in this Chinese hospital were represented by four global clones. Serotypes for these as well as more obscure strains were readily determined by using PCR.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.035675-0
2012-01-01
2024-11-02
Loading full text...

Full text loading...

/deliver/fulltext/jmm/61/1/42.html?itemId=/content/journal/jmm/10.1099/jmm.0.035675-0&mimeType=html&fmt=ahah

References

  1. Beall B., McEllistrem M. C., Gertz R. E. Jr, Wedel S., Boxrud D. J., Gonzalez A. L., Medina M. J., Pai R., Thompson T. A. other authors 2006; Pre- and postvaccination clonal compositions of invasive pneumococcal serotypes for isolates collected in the United States in 1999, 2001, and 2002. J Clin Microbiol 44:999–1017 [View Article][PubMed]
    [Google Scholar]
  2. Beall B. W., Gertz R. E. Jr, Hulkower R. L., Whitney C. G., Moore M. R., Brueggemann A. B. 2011; Shifting genetic structure of invasive serotype 19A pneumococci in the United States. J Infect Dis 203:1360–1368 [View Article][PubMed]
    [Google Scholar]
  3. Carvalho M. da G., Pimenta F. C., Jackson D., Roundtree A., Ahmad Y., Millar E. V., O’Brien K. L., Whitney C. G., Cohen A. L., Beall B. W. 2010; Revisiting pneumococcal carriage by use of broth enrichment and PCR techniques for enhanced detection of carriage and serotypes. J Clin Microbiol 48:1611–1618 [View Article][PubMed]
    [Google Scholar]
  4. CLSI 2007; Performance Standards for Antimicrobial Susceptibility Testing, approved standard, 16th informational supplement, M100–S17. Wayne, PA: Clinical and Laboratory Standards Institute;
  5. CLSI 2011; Performance Standards for Antimicrobial Susceptibility Testing, approved standard, 16th informational supplement, M100–S21. Wayne, PA: Clinical and Laboratory Standards Institute;
  6. Dias C. A., Teixeira L. M., Carvalho M. G., Beall B. 2007; Sequential multiplex PCR for determining capsular serotypes of pneumococci recovered from Brazilian children. J Med Microbiol 56:1185–1188 [View Article][PubMed]
    [Google Scholar]
  7. Enright M. C., Spratt B. G. 1998; A multilocus sequence typing scheme for Streptococcus pneumoniae: identification of clones associated with serious invasive disease. Microbiology 144:3049–3060 [View Article][PubMed]
    [Google Scholar]
  8. Moore M. R., Gertz R. E. Jr, Woodbury R. L. G., Barkocy-Gallagher G. A., Schaffner W., Lexau C., Gershman K., Reingold A., Farley M. other authors 2008; Population snapshot of emergent Streptococcus pneumoniae serotype 19A in the United States, 2005. J Infect Dis 197:1016–1027 [View Article][PubMed]
    [Google Scholar]
  9. Morais L., Carvalho M. da G., Roca A., Flannery B., Mandomando I., Soriano-Gabarró M., Sigauque B., Alonso P., Beall B. 2007; Sequential multiplex PCR for identifying pneumococcal capsular serotypes from South-Saharan African clinical isolates. J Med Microbiol 56:1181–1184 [View Article][PubMed]
    [Google Scholar]
  10. O’Brien K. L., Wolfson L. J., Watt J. P., Henkle E., Deloria-Knoll M., McCall N., Lee E., Mulholland K., Levine O. S., Cherian T. for the Hib and Pneumococcal Global Burden of Disease Study Team 2009; Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates. Lancet 374:893–902 [View Article][PubMed]
    [Google Scholar]
  11. Pai R., Gertz R. E. Jr, Beall B. 2006; Sequential multiplex PCR approach for determining capsular serotypes of Streptococcus pneumoniae isolates. J Clin Microbiol 44:124–131 [View Article][PubMed]
    [Google Scholar]
  12. Pilishvili T., Lexau C., Farley M. M., Hadler J., Harrison L. H., Bennett N. M., Reingold A., Thomas A., Schaffner W. other authors 2010; Sustained reductions in invasive pneumococcal disease in the era of conjugate vaccine. J Infect Dis 201:32–41 [View Article][PubMed]
    [Google Scholar]
  13. Tarragó D., Aguilar L., García R., Gimenez M. J., Granizo J. J., Fenoll A. 2011; Evolution of clonal and susceptibility profiles of serotype 19A Streptococcus pneumoniae among invasive isolates from children in Spain, 1990 to 2008. Antimicrob Agents Chemother 55:2297–2302 [View Article][PubMed]
    [Google Scholar]
  14. Toltzis P., Dul M. M., O’Riordan M. A., Jacobs M. R., Blumer J. 2006; Serogroup 19 pneumococci containing both mef and erm macrolide resistance determinants in an American city. Pediatr Infect Dis J 25:19–24 [View Article][PubMed]
    [Google Scholar]
  15. Waites K. B., Jones K. E., Kim K. H., Moser S. A., Johnson C. N., Hollingshead S. K., Kang E. S., Hong K. S., Benjamin W. H. Jr 2003; Dissemination of macrolide-resistant Streptococcus pneumoniae isolates containing both erm(B) and mef(A) in South Korea. J Clin Microbiol 41:5787–5791 [View Article][PubMed]
    [Google Scholar]
  16. Yao K. H., Wang L. B., Zhao G. M., Zheng Y. J., Deng L., Huang J. F., Wang J. X., Zhao R. Z., Deng Q. L., Hu Y.-H. 2011; Pneumococcal serotype distribution and antimicrobial resistance in Chinese children hospitalized for pneumonia. Vaccine 29:2296–2301 [View Article][PubMed]
    [Google Scholar]
  17. Zhang R., Eggleston K., Rotimi V., Zeckhauser R. J. 2006; Antibiotic resistance as a global threat: evidence from China, Kuwait and the United States. Global Health 2:6 [View Article][PubMed]
    [Google Scholar]
/content/journal/jmm/10.1099/jmm.0.035675-0
Loading
/content/journal/jmm/10.1099/jmm.0.035675-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error