Erythromycin resistance in invasive serotype 14 pneumococci is highly related to clonal type

Clarke, Stuart C.; Scott, Kevin J.; McChlery, S. M.

doi:10.1099/jmm.0.45737-0

Cited by 10 publications

(10 citation statements)

References 20 publications

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“…These results are in line with results from Germany published previously by the NRCS for invasive [14] and respiratory tract isolates [37] and comparable to results reported from several European countries [3,13,38,39]. Notably, a statistically significant trend in increasing macrolide resistance was seen for serotypes 14 and 19F.…”

Section: Discussionsupporting

confidence: 91%

Macrolide susceptibility and serotype specific macrolide resistance of invasive isolates of Streptococcus pneumoniae in Germany from 1992 to 2008

et al. 2010

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BackgroundMacrolide resistant Streptococcus pneumoniae has been on a gradual increase in Germany for over a decade. The current study was undertaken against the background of the recent observation of declining macrolide resistance rates especially among German children. Nationwide surveillance of invasive pneumococcal disease has been conducted in Germany since 1992. A population- and laboratory-based approach was used to collect data on invasive pneumococcal disease, and isolates sent to the National Reference Center for Streptococci by diagnostic microbiological laboratories from 1992 to 2008 were included in this study.ResultsFrom 1992 to 2008, data on macrolide susceptibility were available for 11,807 invasive isolates. 8,834 isolates (74.8%) were from adults (≥ 16 years), and 2,973 isolates (25.2%) from children (< 16 years). The overall nonsusceptibility rate of all isolates was 16.2% (intermediate, 0.2%; resistant, 16.0%). Higher resistance rates were observed among children (intermediate, 0.2%; resistant, 23.8%) than among adults (intermediate, 0.3%; resistant 13.4%). Maximum nonsusceptibility rates during the period under study were observed in 2005 (children: intermediate, 0.3%; resistant, 32.3%; adults: intermediate, 0.0%; resistant, 18.6%), while nonsusceptibility rates in 2008 were considerably lower, especially for children (children: intermediate, 0.0%; resistant, 15.2%; adults: intermediate, 0.1%; resistant, 12.9%). The rate of resistance was higher among the vaccine serotypes (7-valent, 36.6%; 10-valent, 28.2%; 13-valent, 24.3%) than among the non vaccine serotypes (non 7-valent, 6.5%; non 10-valent, 7.4%; non 13-valent, 6.3%). Serotype 14 (69.6% nonsusceptibility) proved to be the most resistant serotype.ConclusionsThere has been a considerable and statistically significant decrease in macrolide nonsusceptibility in Germany since 2005, especially among children.

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Section: Discussionsupporting

confidence: 91%

Macrolide susceptibility and serotype specific macrolide resistance of invasive isolates of Streptococcus pneumoniae in Germany from 1992 to 2008

et al. 2010

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“…Around 11% of all pneumococci are resistant to macrolides in Scotland (12,14), while 60% of serotype 14 pneumococci are macrolide resistant (13). If PCV7 were routinely introduced in the United Kingdom, it is likely that the incidence of antibiotic resistance among pneumococci would fall, simply because the majority of resistant pneumococci are covered by PCV7.…”

Section: Discussionmentioning

confidence: 99%

Potential Impact of Conjugate Vaccine on the Incidence of Invasive Pneumococcal Disease among Children in Scotland

Clarke

Jefferies

Smith³

et al. 2006

J Clin Microbiol

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We sought to determine the potential impact of seven-valent pneumococcal conjugate vaccine on the incidence of invasive pneumococcal disease (IPD) among children in Scotland. Invasive pneumococci from blood and cerebrospinal fluid, isolated between 2000 and 2004 from all children aged less than 5 years in Scotland, were characterized by serotyping. Using reported efficacy data of the seven-valent pneumococcal conjugate vaccine (PCV7) along with likely coverage rates, we made an estimation of the potential impact on the incidence of IPD among children in Scotland. A total of 217 pneumococci were characterized into 22 different serogroups/types, the most common, in rank order, being 14, 19F, 6B, 18C, 23F, 9V, 4, 1, 19A, and 6A. Estimated serotype coverage for PCV7 was 76.5% in those aged less than 5 years of age but increased to 88.9% for those aged 1 year. By using serotype coverage and estimates of vaccine efficacy and uptake, the potential impact of the vaccine for those greater than 2 months of age, but less than 5 years, was estimated as 67.3%, leading to an average of 29 preventable cases per year.

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“…Serotypes/serogroups 6, 9, 14, 19 and 23, which are commonly associated with drug resistance phenotypes [14–17], did not show higher transformation frequencies than serotypes 1, 3 and 18 that are commonly susceptible to antimicrobials. The reason why serotypes/serogroups 6, 9, 14, 19 and 23 are commonly associated with drug resistance phenotypes is still elusive.…”

Section: Discussionmentioning

confidence: 99%

“…Although over 90 pneumococcal serotypes exist and are assumed to be naturally competent for genetic transformation, antibiotic-resistant isolates, including those resistant to penicillin, usually belong to serotypes/serogroups 6, 9, 14, 19 or 23 and to a few defined clonal groups in most parts of the world [11,14–17]. Of these, the serotypes responsible for most pneumococcal disease and drug resistance are 6B, 14, 19F and 23F [18].…”

Section: Introductionmentioning

confidence: 99%

Comparison of transformation frequencies among selected Streptococcus pneumoniae serotypes

Joloba¹,

Kidenya²,

Kateete³

et al. 2010

International Journal of Antimicrobial Agents

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Although there are over 90 serotypes of Streptococcus pneumoniae, antimicrobial resistance is predominantly found in a limited number of serotypes/serogroups, namely 6, 9, 14, 19 and 23. There is no compelling mechanism to account for this restriction. We aimed to determine whether serotypes commonly associated with drug resistance have higher transformation frequencies than those that are susceptible to antimicrobial agents. An in vitro investigation of the genetic transformation frequency of drug-resistant serotypes compared with that of susceptible serotypes under the influence of synthetic competence-stimulating peptides was performed. The transforming DNA was genomic DNA carrying a Tn916-like transposon containing the mefE gene that confers resistance to erythromycin. It was observed that serotypes 6, 9, 14, 19 and 23, which are highly associated with drug resistance, do not exhibit a higher degree of transformation efficiency than other serotypes. These findings suggest that the association of serotype with drug resistance is likely due to prolonged exposure to transforming DNA resulting from longer nasopharyngeal carriage and to a greater selective pressure from antimicrobials, particularly in children. This is the first study to compare the transformation frequencies of pneumococcal clinical isolates using genomic DNA that carries the composite Tn916-like element.

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Erythromycin resistance in invasive serotype 14 pneumococci is highly related to clonal type

Cited by 10 publications

References 20 publications

Macrolide susceptibility and serotype specific macrolide resistance of invasive isolates of Streptococcus pneumoniae in Germany from 1992 to 2008

Macrolide susceptibility and serotype specific macrolide resistance of invasive isolates of Streptococcus pneumoniae in Germany from 1992 to 2008

Potential Impact of Conjugate Vaccine on the Incidence of Invasive Pneumococcal Disease among Children in Scotland

Comparison of transformation frequencies among selected Streptococcus pneumoniae serotypes

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