Epidemiology and Antimicrobial Resistance of Streptococcus pneumoniae in France in 2007: Data from the Pneumococcus Surveillance Network

Abstract

Antimicrobial resistance of Streptococcus pneumoniae in France is closely monitored by the pneumococcus surveillance network, founded in 1995, which collects data from regional observatories (Observatoire Régionaux du Pneumocoque [ORP]). In 2007, 23 ORPs analyzed the antibiotic susceptibility of 5,302 isolates of S. pneumoniae recovered in France from cerebrospinal fluid, blood, middle ear fluid, and pleural fluid, as well as from adult respiratory samples. The study showed that 38.2% of the strains were nonsusceptible to penicillin, 19.3% nonsusceptible to amoxicillin, and 10.5% nonsusceptible to cefotaxime. The percentage of pneumococcus nonsusceptible to penicillin varied according to both the sample and the age of the patient (child/adult): blood (27.8%/32.5%), cerebrospinal fluid (33.7%/34.6%), middle ear fluid (60.2%/27.5%), and pleural fluid (50.0%/31.0%). Between 2003 and 2007, the frequency of penicillin resistance in invasive pneumococcal disease gradually decreased from 46.4% to 29.0% in children and from 43.8% to 32.7% in adults. This decrease coincided with the introduction of a seven-valent pneumococcal conjugate vaccine into immunization programs and with a general reduction in levels of antibiotic consumption in France.

Western Europe

“…Rates in Belgium are a little bit higher (4%) but in other regions can be much higher, up to 38% [49][50][51]. In most instances, amoxicillin-clavulanic acid is still effective.…”

Invasive Pneumococcal Disease in Children: The Contribution of Real-Time PCR on Blood

“…Amplifications were performed in a Smart Cycler® (Instrumentation Laboratory) with the final reaction mix containing 5 µL of DNA, 12.5 µL of Premix Ex Taq (TaKaRa®, Foster city, USA), 4.4 µL of water, 2.5 µL of SYBR® Green and 0.3 µL of each primer. The S. pneumoniae positive DNA control was from the reference strain R6 and was also included with each set of amplifications [10]. Thermal cycling conditions for ply and lytA were as follows: 1 cycle of 10s at 95°C followed by 40 cycles of 5s at 95°C and 20s at 60°C.…”

On the importance of composite protein multiple ligand interactions in protein pockets

“…The effect of these mutations on drug binding and drug response depends on the residue that gets mutated and its three‐dimensional structural context . Several examples have been presented in the literature which show that mutation of critical amino acid residues in the pocket leads to widespread drug‐resistance . For example, the T315I gatekeeper mutation in the Abl kinase domain acquired after treatment with ATP analogues leads to ∼20% of patients having clinically acquired resistance .…”