Antimicrobial resistance of invasive Streptococcus pneumoniae isolates in a British district general hospital: the international connection

Abstract

Between January 2000 and March 2001, Streptococcus pneumoniae were isolated from the blood of 56 patients admitted to a single district general hospital in the South-East of England. The serotype and antibiotic susceptibility were determined for all isolates and, for those resistant to erythromycin, the presence or absence of the mef(A) and erm(B) genes was determined by PCR. Multi-locus sequence typing, along with PFGE, was undertaken on all isolates resistant to penicillin or erythromycin and a group of antibiotic-susceptible isolates, to identify whether globally distributed pneumococcal clones, as described by the Pneumococcal Molecular Epidemiology Network (PMEN), were present in the study population. Three serotype 9V penicillin-resistant isolates were identified as belonging to the Spain9V-3 clone, while 14 erythromycin-resistant isolates of serotype 14 belonged to the England14-9 clone. A single multi-resistant isolate of serotype 6B, was found to be a single-locus variant of the Spain6B-2 clone. All 14 erythromycin-resistant serotype 14 isolates possessed the mef(A) gene, while the single multi-resistant isolate possessed the erm(B) gene. These findings confirm the wide distribution and clinical impact of PMEN clones, which accounted for all of the penicillin and erythromycin resistance observed amongst invasive isolates in a district general hospital over a 15-month period.

Frontline antibiotic therapy

“…17 This is mainly attributable to the reduction in serotype 14, which has been strongly associated with erythromycin resistance. 18 Resistance patterns of streptococci in general (α, β and nonhaemolytic) against β-lactam and non-β-lactam agents (erythromycin, clindamycin, tetracycline and gentamicin) have remained stable over the past decade. 19 On the other hand, resistance to ampicillin, vancomycin and gentamicin has increased among Enterococcus faecium (E. faecium): currently, Ͼ95% of E. faecium are resistant to amoxicillin, 25% to vancomycin and 50% have high-level resistance to gentamicin.…”

Integrated Multilevel Surveillance of the World's Infecting Microbes and Their Resistance to Antimicrobial Agents

“…Some clinical care laboratories now do or ask reference laboratories to do genotyping of selected isolates. Often used among the many genotyping methods are specific gene probes (126), pulsed-field gel electrophoresis (56), multilocus sequence typing (MLST) (10,88), and microarrays (62). The European Antimicrobial Resistance Surveillance System (EARSS) program is now using selective spa typing to delineate the finer-scale epidemiology of MRSA over a continent (88,120).…”

Cytotoxic Molecules from Natural Sources: Tapping the Brazilian Biodiversity

“…The development of multi-resistant strains of bacteria has been a major concern of microbiologists around the world [6,7,8,9]. Infections are still considered one of the main causes of human and animal deaths.…”