title: Clonal spread of mef-positive macrolide-resistant Streptococcus pneumoniae isolates causing invasive disease in adults in Germany.
abstract: Isolates (3,845) obtained from German adults with invasive pneumococcal disease between 1992 and 2004 were investigated. Of these, 430 isolates (11.2%) were erythromycin A nonsusceptible. Macrolide resistance genotypes and multilocus sequence types were determined. Among the isolates, 35.6% were erm(B) positive and 63.5% were mef positive. Over the study period, the frequency of resistance rose significantly from 2.2 to 17.0% (P < 0.001). A serotype 14, sequence type 9 clone was the most widespread.
authors.affiliation: Institute for Medical Microbiology, National Reference Center for Streptococci, University Hospital, Pauwelsstr 30, Aachen, Germany.
authors.forename: Mark
authors.initials: M
authors.lastname: van der Linden
authors.forename: Adnan
authors.initials: A
authors.lastname: Al-Lahham
authors.forename: Stefan
authors.initials: S
authors.lastname: Haupts
authors.forename: Ralf René
authors.initials: RR
authors.lastname: Reinert
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics*; D024881:Drug Resistance, Bacterial; D004917:Erythromycin / Q000494:pharmacology*; D006801:Humans; D018942:Macrolides / Q000494:pharmacology*; D008565:Membrane Proteins / Q000235:genetics*; D011008:Pneumococcal Infections / Q000382:microbiology*; D017422:Sequence Analysis, DNA; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D018942:Macrolides; C117866:MefA protein, Streptococcus; D008565:Membrane Proteins; D004917:Erythromycin