Fluoroquinolone Resistance in Penicillin-resistantStreptococcus pneumoniaeClones, Spain

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...

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Detalles Bibliográficos
Autores: de la Campa, Adela G, Balsalobre-Arenas, Maria Luz, Ardanuy, Carmen, Fenoll, Asuncion, Pérez-Trallero, Emilio, Liñares, Josefina
Tipo de recurso: artículo
Fecha de publicación:2004
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/7412
Acceso en línea:http://hdl.handle.net/20.500.12105/7412
Access Level:acceso abierto
Palabra clave:Adult
Base Sequence
Child
DNA Gyrase
DNA Topoisomerase IV
DNA, Bacterial
Fluoroquinolones
Humans
Microbial Sensitivity Tests
Molecular Epidemiology
Penicillin Resistance
Spain
Streptococcal Infections
Streptococcus pneumoniae
Drug Resistance, Multiple, Bacterial
Descripción
Sumario: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.