Changes in fluoroquinolone-resistant Streptococcus pneumoniae after 7-valent conjugate vaccination, Spain

• Published in: Emerging infectious diseases 2009-06, Vol.15 (6), p.905-911
• Main Authors: de la Campa, Adela G, Ardanuy, Carmen, Balsalobre, Luz, Pérez-Trallero, Emilio, Marimón, Jose M, Fenoll, Asunción, Liñares, Josefina
• Format: Article
• Language: English
• Subjects: Adult; Analysis; Anti-Bacterial Agents - pharmacology; Bacterial pneumonia; Bacterial Proteins - genetics; Child; Child, Preschool; Ciprofloxacin; Ciprofloxacin - pharmacology; Drug resistance; Drug Resistance, Bacterial - genetics; Electrophoresis, Gel, Pulsed-Field; Espanya; Estreptococs; Fluoroquinolones - pharmacology; Genotype; Heptavalent Pneumococcal Conjugate Vaccine; Humans; Infeccions per pneumococs; Microbial Sensitivity Tests; Mutation; Pneumococcal Infections; Pneumococcal vaccine; Pneumococcal Vaccines - administration & dosage; Pneumococs; Pneumonia; Prevalence; Resistència als medicaments; Sequence Analysis, DNA; Serotyping; Spain; Spain - epidemiology; Streptococcal Infections - epidemiology; Streptococcal Infections - microbiology; Streptococcal Infections - prevention & control; Streptococcus; Streptococcus pneumonia; Streptococcus pneumoniae; Streptococcus pneumoniae - classification; Streptococcus pneumoniae - drug effects; Streptococcus pneumoniae - enzymology; Streptococcus pneumoniae - genetics; Transformation, Bacterial; Vaccination; Vacuna antipneumocòccica
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid1506.080684

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.