title: Antimicrobial resistance of invasive Streptococcus pneumoniae isolates in a British district general hospital: the international connection.
abstract: Between January 2000 and March 2001, Streptococcus pneumoniae were isolated from the blood of 56 patients admitted to a single district general hospital in the South-East of England. The serotype and antibiotic susceptibility were determined for all isolates and, for those resistant to erythromycin, the presence or absence of the mef(A) and erm(B) genes was determined by PCR. Multi-locus sequence typing, along with PFGE, was undertaken on all isolates resistant to penicillin or erythromycin and a group of antibiotic-susceptible isolates, to identify whether globally distributed pneumococcal clones, as described by the Pneumococcal Molecular Epidemiology Network (PMEN), were present in the study population. Three serotype 9V penicillin-resistant isolates were identified as belonging to the Spain9V-3 clone, while 14 erythromycin-resistant isolates of serotype 14 belonged to the England14-9 clone. A single multi-resistant isolate of serotype 6B, was found to be a single-locus variant of the Spain6B-2 clone. All 14 erythromycin-resistant serotype 14 isolates possessed the mef(A) gene, while the single multi-resistant isolate possessed the erm(B) gene. These findings confirm the wide distribution and clinical impact of PMEN clones, which accounted for all of the penicillin and erythromycin resistance observed amongst invasive isolates in a district general hospital over a 15-month period.
authors.affiliation: Respiratory and Systemic Infection Laboratory1 and Antibiotic Resistance Monitoring and Reference Laboratory3, Specialist and Reference Microbiology Division, Health Protection Agency, London NW9 5HT, UK 2Reading Public Health Laboratory, London Road, Reading RG1 5AN, UK 4Department of Biological Sciences, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Birtles
authors.affiliation: Respiratory and Systemic Infection Laboratory1 and Antibiotic Resistance Monitoring and Reference Laboratory3, Specialist and Reference Microbiology Division, Health Protection Agency, London NW9 5HT, UK 2Reading Public Health Laboratory, London Road, Reading RG1 5AN, UK 4Department of Biological Sciences, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK.
authors.forename: Nilangi
authors.initials: N
authors.lastname: Virgincar
authors.affiliation: Respiratory and Systemic Infection Laboratory1 and Antibiotic Resistance Monitoring and Reference Laboratory3, Specialist and Reference Microbiology Division, Health Protection Agency, London NW9 5HT, UK 2Reading Public Health Laboratory, London Road, Reading RG1 5AN, UK 4Department of Biological Sciences, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK.
authors.forename: Carmen L
authors.initials: CL
authors.lastname: Sheppard
authors.affiliation: Respiratory and Systemic Infection Laboratory1 and Antibiotic Resistance Monitoring and Reference Laboratory3, Specialist and Reference Microbiology Division, Health Protection Agency, London NW9 5HT, UK 2Reading Public Health Laboratory, London Road, Reading RG1 5AN, UK 4Department of Biological Sciences, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Walker
authors.affiliation: Respiratory and Systemic Infection Laboratory1 and Antibiotic Resistance Monitoring and Reference Laboratory3, Specialist and Reference Microbiology Division, Health Protection Agency, London NW9 5HT, UK 2Reading Public Health Laboratory, London Road, Reading RG1 5AN, UK 4Department of Biological Sciences, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK.
authors.forename: Alan P
authors.initials: AP
authors.lastname: Johnson
authors.affiliation: Respiratory and Systemic Infection Laboratory1 and Antibiotic Resistance Monitoring and Reference Laboratory3, Specialist and Reference Microbiology Division, Health Protection Agency, London NW9 5HT, UK 2Reading Public Health Laboratory, London Road, Reading RG1 5AN, UK 4Department of Biological Sciences, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK.
authors.forename: Marina
authors.initials: M
authors.lastname: Warner
authors.affiliation: Respiratory and Systemic Infection Laboratory1 and Antibiotic Resistance Monitoring and Reference Laboratory3, Specialist and Reference Microbiology Division, Health Protection Agency, London NW9 5HT, UK 2Reading Public Health Laboratory, London Road, Reading RG1 5AN, UK 4Department of Biological Sciences, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK.
authors.forename: Valerie
authors.initials: V
authors.lastname: Edwards-Jones
authors.affiliation: Respiratory and Systemic Infection Laboratory1 and Antibiotic Resistance Monitoring and Reference Laboratory3, Specialist and Reference Microbiology Division, Health Protection Agency, London NW9 5HT, UK 2Reading Public Health Laboratory, London Road, Reading RG1 5AN, UK 4Department of Biological Sciences, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK.
authors.forename: Robert C
authors.initials: RC
authors.lastname: George
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D015373:Bacterial Typing Techniques; D016172:DNA Fingerprinting; D024881:Drug Resistance, Bacterial; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D004739:England / Q000453:epidemiology; D006769:Hospitals, General; D006801:Humans; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D011008:Pneumococcal Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*; D015995:Prevalence; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents