Fluoroquinolone resistance in penicillin-resistant Streptococcus pneumoniae clones, Spain.

Abstract:

:Among 2,882 Streptococcus pneumoniae sent to the Spanish Reference Laboratory during 2002, 75 (2.6%) were ciprofloxacin-resistant. Resistance was associated with older patients (3.9% in adults and 7.2% in patients > or =65 years of age), with isolation from noninvasive sites (4.3% vs. 1.0%), and with penicillin and macrolide resistance. Among 14 low-level resistant (MIC 4-8 microg/mL) strains, 1 had a fluoroquinolone efflux phenotype, and 13 showed single ParC changes. The 61 high-level ciprofloxacin-resistant (MIC > or =16 microg/mL) strains showed either two or three changes at ParC, ParE, and GyrA. Resistance was acquired either by point mutation (70 strains) or by recombination with viridans streptococci (4 strains) at the topoisomerase II genes. Although 36 pulsed-field gel electrophoresis patterns were observed, 5 international multiresistant clones (Spain23F-1, Spain6B-2, Spain9V-3, Spain14-5 and Sweden15A-25) accounted for 35 (46.7%) of the ciprofloxacin-resistant strains. Continuous surveillance is needed to prevent the dissemination of these clones.

journal_name

Emerg Infect Dis

authors

de la Campa AG,Balsalobre L,Ardanuy C,Fenoll A,Pérez-Trallero E,Liñares J,Spanish Pneumococcal Infection Study Network G03\/103.

doi

10.3201/eid1010.040382

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

1751-9

issue

10

eissn

1080-6040

issn

1080-6059

journal_volume

10

pub_type

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