title: Clonally related penicillin-nonsusceptible Streptococcus pneumoniae serotype 14 from cases of meningitis in Salvador, Brazil.
abstract: Active hospital-based surveillance in the city of Salvador, Brazil, from December 1995 through October 1998, identified 221 patients with confirmed pneumococcal meningitis. Of these 221 patients, 29 (13%) had isolates with intermediate-level resistance to penicillin. Infection with these penicillin-nonsusceptible isolates was significantly associated with age of <2 years (P<.0019), previous antibiotic use (P<.0006), and coresistance to trimethoprim-sulfamethoxazole (P<.0000). Serotype 14 was the most prevalent serotype (55.2%) of penicillin-nonsusceptible isolates. Strain typing by repetitive element BOX polymerase chain reaction (PCR) analysis showed that penicillin-nonsusceptible serotype 14 isolates had closely related BOX PCR patterns, whereas penicillin-susceptible serotype 14 isolates each had distinct, unrelated patterns. Penicillin-nonsusceptible serotype 14 isolates from Salvador and other Brazilian cities had similar BOX PCR patterns. These observations indicate that in Brazil a large proportion of cases of penicillin-nonsusceptible pneumococcal meningitis appear to be caused by a closely related group of serotype 14 strains that may have disseminated to widely separate geographic areas.
authors.affiliation: Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz/Ministério da Saúde, Bahia 40295-001, Brazil. albertko@cpunet. com.br
authors.forename: A I
authors.initials: AI
authors.lastname: Ko
authors.forename: J N
authors.initials: JN
authors.lastname: Reis
authors.forename: S J
authors.initials: SJ
authors.lastname: Coppola
authors.forename: E L
authors.initials: EL
authors.lastname: Gouveia
authors.forename: S M
authors.initials: SM
authors.lastname: Cordeiro
authors.forename: T S
authors.initials: TS
authors.lastname: Lôbo
authors.forename: R M
authors.initials: RM
authors.lastname: Pinheiro
authors.forename: K
authors.initials: K
authors.lastname: Salgado
authors.forename: C M
authors.initials: CM
authors.lastname: Ribeiro Dourado
authors.forename: J
authors.initials: J
authors.lastname: Tavares-Neto
authors.forename: H
authors.initials: H
authors.lastname: Rocha
authors.forename: M
authors.initials: M
authors.lastname: Galvão Reis
authors.forename: W D
authors.initials: WD
authors.lastname: Johnson
authors.forename: L W
authors.initials: LW
authors.lastname: Riley
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008586:Meningitis, Pneumococcal / Q000453:epidemiology* / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D016133:Polymerase Chain Reaction / Q000379:methods; D011159:Population Surveillance; D012307:Risk Factors; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents