Fluoroquinolone resistance in penicillin-resistant Streptococcus pneumoniae clones, 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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Bibliographic Details
Published in:Emerging infectious diseases 2004-10, Vol.10 (10), p.1751-1759
Main Authors: de la Campa, Adela G, Balsalobre, Luz, Ardanuy, Carmen, Fenoll, Asunción, Pérez-Trallero, Emilio, Liñares, Josefina
Format: Article
Language:English
Subjects:
Adult
Base Sequence
Child
DNA Gyrase - genetics
DNA Topoisomerase IV - genetics
DNA topoisomerases
DNA, Bacterial - analysis
Drug resistance
Drug resistance in microorganisms
Drug Resistance, Multiple, Bacterial - genetics
Espanya
Farmacocinètica
Farmacologia
fluoroquinolones
Fluoroquinolones - pharmacology
Genetics
Genètica
Humans
Microbial Sensitivity Tests
Molecular Epidemiology
Penicillin Resistance
Pharmacokinetics
Pharmacology
pneumococcus
Pneumococs
Quinolone antibacterial agents
Quinolones
Resistència als medicaments
Spain
Spain - epidemiology
Streptococcal Infections - epidemiology
Streptococcal Infections - microbiology
Streptococcus pneumonia
Streptococcus pneumoniae
Streptococcus pneumoniae - drug effects
Streptococcus pneumoniae - enzymology
Streptococcus pneumoniae - genetics
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Summary: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.
ISSN:1080-6040
1080-6059
DOI:10.3201/eid1010.040382