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Emergence and spread of Streptococcus pneumoniae with erm(B) and mef(A) resistance.

Farrell DJ, Jenkins SG, Brown SD, Patel M, Lavin BS, Klugman KP - Emerging Infect. Dis. (2005)

Bottom Line: Of 152 representative erm(B)+mef(A) isolates, >90% were clonally related to the multidrug-resistant international Taiwan19F-14 clonal complex 271 (CC271).Of 366 erm(B)+mef(A) isolates from the PROTEKT global study (1999-2003), 83.3% were CC271, with the highest prevalence seen in South Africa, South Korea, and the United States.This study confirms the increasing global emergence and rapidly increasing US prevalence of this multidrug-resistant pneumococcal clone.

View Article: PubMed Central - PubMed

Affiliation: G.R. Micro Ltd, London, United Kingdom. d.farrell@grmicro.co.uk

ABSTRACT
Streptococcus pneumoniae isolates (N = 31,001) were collected from patients with community-acquired respiratory tract infections during the PROTEKT US surveillance study (2000-2003). While the macrolide (erythromycin) resistance rate remained stable at approximately 29%, the prevalence of resistant isolates containing both erm(B) and mef(A) increased from 9.7% in year 1 to 16.4% in year 3, with substantial regional variability. Almost all (99.2%) dual erm(B) + mef(A) macrolide-resistant isolates exhibited multidrug resistance, whereas 98.6% and 99.0% were levofloxacin- and telithromycin-susceptible, respectively. These strains were most commonly isolated from the ear or middle-ear fluid of children. Of 152 representative erm(B)+mef(A) isolates, >90% were clonally related to the multidrug-resistant international Taiwan19F-14 clonal complex 271 (CC271). Of 366 erm(B)+mef(A) isolates from the PROTEKT global study (1999-2003), 83.3% were CC271, with the highest prevalence seen in South Africa, South Korea, and the United States. This study confirms the increasing global emergence and rapidly increasing US prevalence of this multidrug-resistant pneumococcal clone.

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Phylogenetic relationships of the 82 different sequence type variations found in 518 Streptococcus pneumoniae isolates with combined erm(B)- and mef(A)-mediated macrolide resistance collected during the PROTEKT global study (1999–2003, n = 366) and the PROTEKT US study (2000–2003, n = 152) compared with the 20 PMEN (Pneumococcal Molecular Epidemiology Network [29]) clones.
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Figure 1: Phylogenetic relationships of the 82 different sequence type variations found in 518 Streptococcus pneumoniae isolates with combined erm(B)- and mef(A)-mediated macrolide resistance collected during the PROTEKT global study (1999–2003, n = 366) and the PROTEKT US study (2000–2003, n = 152) compared with the 20 PMEN (Pneumococcal Molecular Epidemiology Network [29]) clones.

Mentions: The results of MLST determination on 518 S. pneumoniae isolates (366 from PROTEKT global [including 35 from the United States] and 152 from PROTEKT US) with dual erm(B)+mef(A)–encoded resistance showed 82 ST variants (Figure). Of these, 21 were in the MLST database, and 61 were submitted to the database and assigned a new ST (STs 1407–1467). All of the unique STs were serotyped and, together with the 20 S. pneumoniae clones listed by the Pneumococcal Molecular Epidemiology Network (29), were analyzed for clonal relatedness by using UPGMA and BURST (Figure). Both the serotype distribution and range of MLSTs in these isolates were limited (Table 5), with 3 clonal complexes predominating. A phylogenetic analysis of these variations showed that 45 of the 82 STs were closely related, either serotype 19F or 19A (Table 5). These strains were of ancestral ST 271 and hence were designated clonal complex (CC) 271, which is equivalent to CC I (15) and CC 236 (22). Overall, 305 (83.3%) of 366 global isolates had MLST profiles consistent with this clone (Table 6).


Emergence and spread of Streptococcus pneumoniae with erm(B) and mef(A) resistance.

Farrell DJ, Jenkins SG, Brown SD, Patel M, Lavin BS, Klugman KP - Emerging Infect. Dis. (2005)

Phylogenetic relationships of the 82 different sequence type variations found in 518 Streptococcus pneumoniae isolates with combined erm(B)- and mef(A)-mediated macrolide resistance collected during the PROTEKT global study (1999–2003, n = 366) and the PROTEKT US study (2000–2003, n = 152) compared with the 20 PMEN (Pneumococcal Molecular Epidemiology Network [29]) clones.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3367592&req=5

Figure 1: Phylogenetic relationships of the 82 different sequence type variations found in 518 Streptococcus pneumoniae isolates with combined erm(B)- and mef(A)-mediated macrolide resistance collected during the PROTEKT global study (1999–2003, n = 366) and the PROTEKT US study (2000–2003, n = 152) compared with the 20 PMEN (Pneumococcal Molecular Epidemiology Network [29]) clones.
Mentions: The results of MLST determination on 518 S. pneumoniae isolates (366 from PROTEKT global [including 35 from the United States] and 152 from PROTEKT US) with dual erm(B)+mef(A)–encoded resistance showed 82 ST variants (Figure). Of these, 21 were in the MLST database, and 61 were submitted to the database and assigned a new ST (STs 1407–1467). All of the unique STs were serotyped and, together with the 20 S. pneumoniae clones listed by the Pneumococcal Molecular Epidemiology Network (29), were analyzed for clonal relatedness by using UPGMA and BURST (Figure). Both the serotype distribution and range of MLSTs in these isolates were limited (Table 5), with 3 clonal complexes predominating. A phylogenetic analysis of these variations showed that 45 of the 82 STs were closely related, either serotype 19F or 19A (Table 5). These strains were of ancestral ST 271 and hence were designated clonal complex (CC) 271, which is equivalent to CC I (15) and CC 236 (22). Overall, 305 (83.3%) of 366 global isolates had MLST profiles consistent with this clone (Table 6).

Bottom Line: Of 152 representative erm(B)+mef(A) isolates, >90% were clonally related to the multidrug-resistant international Taiwan19F-14 clonal complex 271 (CC271).Of 366 erm(B)+mef(A) isolates from the PROTEKT global study (1999-2003), 83.3% were CC271, with the highest prevalence seen in South Africa, South Korea, and the United States.This study confirms the increasing global emergence and rapidly increasing US prevalence of this multidrug-resistant pneumococcal clone.

View Article: PubMed Central - PubMed

Affiliation: G.R. Micro Ltd, London, United Kingdom. d.farrell@grmicro.co.uk

ABSTRACT
Streptococcus pneumoniae isolates (N = 31,001) were collected from patients with community-acquired respiratory tract infections during the PROTEKT US surveillance study (2000-2003). While the macrolide (erythromycin) resistance rate remained stable at approximately 29%, the prevalence of resistant isolates containing both erm(B) and mef(A) increased from 9.7% in year 1 to 16.4% in year 3, with substantial regional variability. Almost all (99.2%) dual erm(B) + mef(A) macrolide-resistant isolates exhibited multidrug resistance, whereas 98.6% and 99.0% were levofloxacin- and telithromycin-susceptible, respectively. These strains were most commonly isolated from the ear or middle-ear fluid of children. Of 152 representative erm(B)+mef(A) isolates, >90% were clonally related to the multidrug-resistant international Taiwan19F-14 clonal complex 271 (CC271). Of 366 erm(B)+mef(A) isolates from the PROTEKT global study (1999-2003), 83.3% were CC271, with the highest prevalence seen in South Africa, South Korea, and the United States. This study confirms the increasing global emergence and rapidly increasing US prevalence of this multidrug-resistant pneumococcal clone.

Show MeSH
Related in: MedlinePlus