title: Antimicrobial susceptibilities and distribution of resistance genes for beta-lactams and macrolides in Streptococcus pneumoniae isolated between 2002 and 2004 in Tokyo.
abstract: Antimicrobial susceptibilities of 205 Streptococcus pneumoniae strains isolated between 2002 and 2004 in Japan were examined and the distribution of genes for resistance to penicillins and macrolides were investigated by polymerase chain reaction. The molecular epidemiology of 92 randomly selected isolates was also examined by pulsed-field gel electrophoresis (PFGE). The numbers of S. pneumoniae isolates resistant to benzylpenicillin, clarithromycin and tetracycline were, respectively, 39 (19%), 111 (54%) and 155 (76%), and the numbers increased annually. All isolates were susceptible to amoxicillin, fluoroquinolones, vancomycin and linezolid. Analysis of mutations in the genes for penicillin-binding protein showed that 92% of isolates had mutations in pbp1a, pbp2b and/or pbp2x. Susceptibility to benzylpenicillin decreased with increasing number of mutated pbp genes. The macrolide resistance genes ermB and mefA were found in 99 (48%) and 76 (37%) isolates, respectively. The presence of ermB was associated with high-level resistance to macrolides, and the percentage of isolates with ermB increased annually. The presence of mefA also increased with increasing number of mutated pbp genes. Although the 92 isolates belonged to 74 PFGE types, three groups with an 80% similarity in their PFGE patterns were found at high frequency. Two of the three groups contained no isolates susceptible to penicillin and/or tetracycline, and their percentages increased annually. Our results suggest that the number of S. pneumoniae isolates with reduced susceptibility due to accumulation of resistance genes has been increasing.
authors.affiliation: Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Science, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan. noguchin@ps.toyaku.ac.jp
authors.forename: Norihisa
authors.initials: N
authors.lastname: Noguchi
authors.forename: Junko
authors.initials: J
authors.lastname: Tano
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nasu
authors.forename: Masaharu
authors.initials: M
authors.lastname: Koyama
authors.forename: Koji
authors.initials: K
authors.lastname: Narui
authors.forename: Hajime
authors.initials: H
authors.lastname: Kamishima
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Saito
authors.forename: Kazumitsu
authors.initials: K
authors.lastname: Tsuyuki
authors.forename: Masanori
authors.initials: M
authors.lastname: Sasatsu
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D004269:DNA, Bacterial / Q000032:analysis; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D018942:Macrolides / Q000494:pharmacology*; D008565:Membrane Proteins / Q000235:genetics; D008780:Methyltransferases / Q000235:genetics; D008826:Microbial Sensitivity Tests; D009154:Mutation; D046915:Penicillin-Binding Proteins / Q000235:genetics; D010453:Peptide Synthases / Q000235:genetics; D010458:Peptidyl Transferases / Q000235:genetics; D010802:Phylogeny; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology; D013045:Species Specificity; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D014041:Tokyo / Q000453:epidemiology; D018440:beta-Lactam Resistance / Q000235:genetics; D047090:beta-Lactams / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004269:DNA, Bacterial; D018942:Macrolides; C117866:MefA protein, Streptococcus; D008565:Membrane Proteins; D046915:Penicillin-Binding Proteins; D047090:beta-Lactams; C478699:penicillin-binding protein 2a, Streptococcus; C072223:PBP 2x protein, Streptococcus; D008780:Methyltransferases; C480727:PBP1a protein, Streptococcus pneumoniae; D010458:Peptidyl Transferases; D010453:Peptide Synthases