title: Nosocomial outbreak of Streptococcus pneumoniae Spain9V‑ST156‑14 clone in a pulmonary diseases ward.
abstract: BACKGROUND
  Streptococcus pneumoniae (S. pneumoniae) is one of the most common bacterial pathogens in community‑acquired pneumonia. However, nosocomial pneumococcal infections are more and more widely observed.
  
  
  OBJECTIVE
  The aim of the study was to analyze nosocomial outbreak in one of the Polish hospitals and to characterize the causative isolates.
  
  
  METHODS
  Within 10 days, in 6 patients receiving an antimicrobial therapy due to a primary disease, pneumococcal infections of the lower respiratory tract were identified. All patients, except 1 patient with asthma, were hospitalized due to exacerbation of chronic obstructive pulmonary disease (COPD). The isolates were identified by standard methods. The serotypes of S. pneumoniae were determined by the Pneumotest‑Latex kit. The relatedness among isolates was evaluated by restriction fragment length polymorphism followed by pulsed‑field gel electrophoresis (RFLP‑PFGE). Multilocus sequence typing (MLST) was performed for a representative isolate.
  
  
  RESULTS
  The outbreak was suspected when characteristic multidrug‑resistant pneumococci were isolated from patients of a single ward. The outbreak was confirmed by molecular typing techniques. All isolates belonged to serotype 14 and shared the RFLP‑PFGE pattern. MLST for a representative isolate revealed that it was a member of the epidemic Spain9V‑ST156 clonal complex.
  
  
  CONCLUSIONS
  Timely implementation of infection control measures enabled to eradicate the outbreak. Pneumococcal conjugate vaccine, recently registered for use in adult populations, may have a considerable effect on limiting pneumococcal disease‑associated morbidity and mortality. It is especially important for patients with COPD, a disease entity that constitutes a risk factor for the acquisition of multidrug‑resistant pneumococci.
authors: Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warszawa, Poland. skoczek@cls.edu.pl
authors: Anna
authors: A
authors: Skoczyńska
authors: Ewa
authors: E
authors: Sadowy
authors: Dorota
authors: D
authors: Krawiecka
authors: Małgorzata
authors: M
authors: Czajkowska-Malinowska
authors: Anna
authors: A
authors: Ciesielska
authors: Grzegorz
authors: G
authors: Przybylski
authors: Renata
authors: R
authors: Zebracka
authors: Waleria
authors: W
authors: Hryniewicz
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000235:genetics*; D003428:Cross Infection / Q000382:microbiology*; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008875:Middle Aged; D008969:Molecular Sequence Data; D010453:Peptide Synthases / Q000235:genetics*; D010458:Peptidyl Transferases / Q000235:genetics; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D011110:Polymorphism, Genetic; D012150:Polymorphism, Restriction Fragment Length; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D012703:Serotyping; D013045:Species Specificity; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000302:isolation & purification
chemical_list: D001426:Bacterial Proteins; D010458:Peptidyl Transferases; C408066:MurM protein, Streptococcus pneumoniae; D010453:Peptide Synthases