title: Changes in fluoroquinolone-resistant Streptococcus pneumoniae after 7-valent conjugate vaccination, Spain.
abstract: Among 4,215 Streptococcus pneumoniae isolates obtained in Spain during 2006, 98 (2.3%) were ciprofloxacin resistant (3.6% from adults and 0.14% from children). In comparison with findings from a 2002 study, global resistance remained stable. Low-level resistance (30 isolates with MIC 4-8 microg/mL) was caused by a reserpine-sensitive efflux phenotype (n = 4) or single topoisomerase IV (parC [n = 24] or parE [n = 1]) changes. One isolate did not show reserpine-sensitive efflux or mutations. High-level resistance (68 isolates with MIC >or=16 microg/mL) was caused by changes in gyrase (gyrA) and parC or parE. New changes in parC (S80P) and gyrA (S81V, E85G) were shown to be involved in resistance by genetic transformation. Although 49 genotypes were observed, clones Spain9V-ST156 and Sweden15A-ST63 accounted for 34.7% of drug-resistant isolates. In comparison with findings from the 2002 study, clones Spain14-ST17, Spain23F-ST81, and ST8819F decreased and 4 new genotypes (ST9710A, ST57016, ST43322, and ST71733) appeared in 2006.
authors.affiliation: Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Adela G
authors.initials: AG
authors.lastname: de la Campa
authors.forename: Carmen
authors.initials: C
authors.lastname: Ardanuy
authors.forename: Luz
authors.initials: L
authors.lastname: Balsalobre
authors.forename: Emilio
authors.initials: E
authors.lastname: Pérez-Trallero
authors.forename: Jose M
authors.initials: JM
authors.lastname: Marimón
authors.forename: Asunción
authors.initials: A
authors.lastname: Fenoll
authors.forename: Josefina
authors.initials: J
authors.lastname: Liñares
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000494:pharmacology; D024881:Drug Resistance, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D024841:Fluoroquinolones / Q000494:pharmacology*; D005838:Genotype; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D008826:Microbial Sensitivity Tests; D009154:Mutation; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D015995:Prevalence; D017422:Sequence Analysis, DNA; D012703:Serotyping; D013030:Spain / Q000453:epidemiology; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D014169:Transformation, Bacterial; D014611:Vaccination
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D024841:Fluoroquinolones; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines; D002939:Ciprofloxacin