title: Dissemination of high-level penicillin-, extended-spectrum cephalosporin-, and erythromycin-resistant Streptococcus pneumoniae clones in Taiwan.
abstract: Sixty-seven clinical isolates of Streptococcus pneumoniae (40 of serotype 23F, 19 of serotype 19F, and 8 of serotype 6B) with decreased susceptibilities to penicillin and erythromycin were characterized by antimicrobial susceptibility patterns; DNA restriction endonuclease cleavage profiles of the penicillin-binding protein genes pbp1a, pbp2b, and pbp2x; random amplified polymorphic DNA (RAPD) patterns generated by arbitrarily primed PCR; and chromosomal macrorestriction profiles based on pulsed-field gel electrophoresis. A total of 22 clones (identical or closely related pulsotypes and identical RAPD patterns) were identified; 14 clones of 23F, 6 of 19F, and 2 of 6B. Three 23F clones (26 isolates) and one 19F clone (9 isolates) expressed high-level resistance to penicillin, cefotaxime, and erythromycin (MICs >/= 256 microg/ml). These data strongly suggest that multiple high-level penicillin-, extended-spectrum cephalosporin-, and macrolide-resistant clones of S. pneumoniae have been disseminated in Taiwan.
authors.affiliation: Departments of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: P R
authors.initials: PR
authors.lastname: Hsueh
authors.forename: L J
authors.initials: LJ
authors.lastname: Teng
authors.forename: L N
authors.initials: LN
authors.lastname: Lee
authors.forename: P C
authors.initials: PC
authors.lastname: Yang
authors.forename: S W
authors.initials: SW
authors.lastname: Ho
authors.forename: K T
authors.initials: KT
authors.lastname: Luh
mesh_terms: D000328:Adult; D019881:Aminoacyltransferases; D001426:Bacterial Proteins; D002352:Carrier Proteins / Q000235:genetics; D002511:Cephalosporins / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D004917:Erythromycin / Q000494:pharmacology*; D005787:Gene Frequency; D006602:Hexosyltransferases; D006801:Humans; D008826:Microbial Sensitivity Tests; D002267:Muramoylpentapeptide Carboxypeptidase / Q000235:genetics; D010403:Penicillin Resistance / Q000235:genetics; D046915:Penicillin-Binding Proteins; D010406:Penicillins / Q000494:pharmacology*; D010458:Peptidyl Transferases; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D013624:Taiwan
chemical_list: D001426:Bacterial Proteins; D002352:Carrier Proteins; D002511:Cephalosporins; D004269:DNA, Bacterial; D046915:Penicillin-Binding Proteins; D010406:Penicillins; D004917:Erythromycin; D019881:Aminoacyltransferases; C478701:penicillin-binding protein 2b, Streptococcus; D010458:Peptidyl Transferases; D006602:Hexosyltransferases; D002267:Muramoylpentapeptide Carboxypeptidase