Abstract
Among 4,215 Streptococcus pneumoniae isolates obtained in Spain during 2006, 98 (2.3%) were ciprofloxacin resistant (3.6% from adults and 0.14% from children). In comparison with findings from a 2002 study, global resistance remained stable. Low-level resistance (30 isolates with MIC 4-8 microg/mL) was caused by a reserpine-sensitive efflux phenotype (n = 4) or single topoisomerase IV (parC [n = 24] or parE [n = 1]) changes. One isolate did not show reserpine-sensitive efflux or mutations. High-level resistance (68 isolates with MIC >or=16 microg/mL) was caused by changes in gyrase (gyrA) and parC or parE. New changes in parC (S80P) and gyrA (S81V, E85G) were shown to be involved in resistance by genetic transformation. Although 49 genotypes were observed, clones Spain9V-ST156 and Sweden15A-ST63 accounted for 34.7% of drug-resistant isolates. In comparison with findings from the 2002 study, clones Spain14-ST17, Spain23F-ST81, and ST8819F decreased and 4 new genotypes (ST9710A, ST57016, ST43322, and ST71733) appeared in 2006.
Highlights
The bacterium Streptococcus pneumoniae is a serious cause of illness and death and a major etiologic agent of community-acquired pneumonia, meningitis, and acute otitis media
Introduction of the 7-valent conjugate pneumococcal vaccine (PCV7), which includes serotypes such as 6B, 9V, 14, and 23F that are often associated with resistance to fluoroquinolones and other antimicrobial drugs, has resulted in changes in the epidemiology of invasive pneumococcal disease [18,19,20]
Isolates were confirmed as S. pneumoniae by standard methods, and serotypes were determined by the Quellung reaction
Summary
The bacterium Streptococcus pneumoniae is a serious cause of illness and death and a major etiologic agent of community-acquired pneumonia, meningitis, and acute otitis media. Introduction of the 7-valent conjugate pneumococcal vaccine (PCV7), which includes serotypes such as 6B, 9V, 14, and 23F that are often associated with resistance to fluoroquinolones and other antimicrobial drugs, has resulted in changes in the epidemiology of invasive pneumococcal disease [18,19,20]. Since the introduction of PCV7 in Spain in late 2001, ≈47% of children have been vaccinated [21]. We investigated the prevalence of fluoroquinolone-resistant pneumococci in Spain during 2006. Resistance associations with other antimicrobial drugs and characteristics of drug-resistant clones were determined. To better evaluate changes in the epidemiology of resistance after the introduction of PCV7 in children, we compared our results with those of a similar study that tested isolates from 2002
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