title: Serotypes and genotypes of Streptococcus pneumoniae causing pneumonia and acute exacerbations in patients with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  This study aimed to compare the antibiotic susceptibilities, serotypes and genotypes of pneumococci causing pneumonia or acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in patients with COPD.
  
  
  METHODS
  A total of 611 pneumococci collected from 487 COPD patients with pneumonia (n = 255, 94 bacteraemic pneumonia) or AECOPD episodes (n = 356), from 2001 to 2008, were analysed. Antibiotic susceptibility was studied by microdilution. Serotypes (PCR or Quellung) and genotypes (PFGE and multilocus sequence typing) were determined.
  
  
  RESULTS
  Pneumococci isolated from AECOPD episodes were significantly more resistant to co-trimoxazole and chloramphenicol than those isolated from pneumonia episodes (39.0% versus 29.7% and 13.8% versus 8.2%, respectively, P < 0.05). Comparing serotypes of isolates causing bacteraemic pneumonia, non-bacteraemic pneumonia and AECOPD, serotypes 4, 5 and 8 were associated with bacteraemic pneumonia (P < 0.05), serotypes 1 and 3 were associated with bacteraemic and non-bacteraemic pneumonia (P < 0.05) and serotypes 16F and 11A and non-typeable pneumococci were associated with AECOPD episodes (P < 0.05). The genotypes related to serotypes 3 (Netherlands(3)-ST180 and ST260(3)), 1 (Sweden(1)-ST306), 5 (Colombia(5)-ST289) and 8 (Netherlands(8)-ST53) were isolated more frequently in pneumonia episodes (P < 0.05), whereas genotype ST30(16F) (serotype 16F) was more frequently recovered from AECOPD episodes.
  
  
  CONCLUSIONS
  In our experience, serotype 3 pneumococci (Netherlands(3)-ST180 and ST260(3) genotypes) commonly cause pneumonia and acute exacerbations in COPD patients. Pneumococci of serotypes 1 (Sweden(1)-ST306), 4 (ST247(4)), 5 (Colombia(5)-ST289) and 8 (Netherlands(8)-ST53) were more often associated with pneumonia. Non-typeable pneumococci may play an important role in acute exacerbations.
authors.affiliation: Microbiology Department, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain.
authors.forename: Arnau
authors.initials: A
authors.lastname: Domenech
authors.forename: Carmen
authors.initials: C
authors.lastname: Ardanuy
authors.forename: Laura
authors.initials: L
authors.lastname: Calatayud
authors.forename: Salud
authors.initials: S
authors.lastname: Santos
authors.forename: Fe
authors.initials: F
authors.lastname: Tubau
authors.forename: Immaculada
authors.initials: I
authors.lastname: Grau
authors.forename: Ricard
authors.initials: R
authors.lastname: Verdaguer
authors.forename: Jordi
authors.initials: J
authors.lastname: Dorca
authors.forename: Román
authors.initials: R
authors.lastname: Pallares
authors.forename: Rogelio
authors.initials: R
authors.lastname: Martin
authors.forename: Josefina
authors.initials: J
authors.lastname: Liñares
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058889:Molecular Typing; D058885:Multilocus Sequence Typing; D010641:Phenotype; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology* / Q000382:microbiology*; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000382:microbiology*; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents