title: Penicillin-resistant Streptococcus pneumoniae in the Netherlands: results of a 1-year molecular epidemiologic survey.
abstract: The molecular epidemiologic characteristics of penicillin-resistant pneumococci in the Netherlands were investigated in 1995. Dutch electronic surveillance data showed that 0.7% of all pneumococci were intermediately resistant and 0.4% were highly resistant to penicillin. From March 1995 to March 1996, 89 penicillin-resistant isolates were collected by 39 medical microbiology laboratories. Thirty different genotypes were observed by restriction fragment end labeling. Twenty-one DNA types were unique, whereas 9 distinct genotypes were shared by > or = 2 isolates. Different serogroups were found within 6 of the 9 genetically identical clusters of penicillin-resistant isolates, suggesting that horizontal transfer of capsular genes is common. Finally, nosocomial transmission of penicillin-resistant pneumococci was observed among 21 elderly adults with chronic obstructive pulmonary disease. This study demonstrates that multiple clones of penicillin-resistant pneumococci have been introduced in the Netherlands, a country with a low prevalence of pneumococcal infection. Some clones spread among the population in and outside hospitals.
authors.affiliation: Department of Pediatrics, University Hospital, Erasmus University, Rotterdam, Netherlands.
authors.forename: P W
authors.initials: PW
authors.lastname: Hermans
authors.forename: M
authors.initials: M
authors.lastname: Sluijter
authors.forename: K
authors.initials: K
authors.lastname: Elzenaar
authors.forename: A
authors.initials: A
authors.lastname: van Veen
authors.forename: J J
authors.initials: JJ
authors.lastname: Schonkeren
authors.forename: F M
authors.initials: FM
authors.lastname: Nooren
authors.forename: W J
authors.initials: WJ
authors.lastname: van Leeuwen
authors.forename: A J
authors.initials: AJ
authors.lastname: de Neeling
authors.forename: B
authors.initials: B
authors.lastname: van Klingeren
authors.forename: H A
authors.initials: HA
authors.lastname: Verbrugh
authors.forename: R
authors.initials: R
authors.lastname: de Groot
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins; D002352:Carrier Proteins / Q000235:genetics; D003428:Cross Infection / Q000382:microbiology; D004196:Disease Outbreaks; D005838:Genotype; D006602:Hexosyltransferases; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000453:epidemiology / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D002267:Muramoylpentapeptide Carboxypeptidase / Q000235:genetics; D009426:Netherlands / Q000453:epidemiology; D010403:Penicillin Resistance / Q000235:genetics*; D046915:Penicillin-Binding Proteins; D010458:Peptidyl Transferases; D010641:Phenotype; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D012150:Polymorphism, Restriction Fragment Length; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D002352:Carrier Proteins; D046915:Penicillin-Binding Proteins; D010458:Peptidyl Transferases; D006602:Hexosyltransferases; D002267:Muramoylpentapeptide Carboxypeptidase