Fluoroquinolone-resistant<i>Streptococcus pneumoniae</i>

Pletz, Mathias W.; Fugit, Randolph V.; McGee, Lesley; Glasheen, Jeffery J.; Keller, Darcie L.; Welte, Tobias; Klugman, Keith P.

doi:10.3201/eid1209.051400

Cited by 17 publications

(11 citation statements)

References 10 publications

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“…The ParC D83G substitution was also found for the first time in this study, particularly among isolates of lineages emm28/ ST52 (n ϭ 1) and emm5/ST99 (n ϭ 1), and was previously described for Streptococcus pneumoniae (21).…”

Section: Another Isolate Was Tetracycline Resistant Carrying Tet(msupporting

confidence: 81%

Emergence of Ciprofloxacin-Nonsusceptible Streptococcus pyogenes Isolates from Healthy Children and Pediatric Patients in Portugal

Pires

Ardanuy

Rolo

et al. 2010

Antimicrob Agents Chemother

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We describe 66 ciprofloxacin-nonsusceptible Streptococcus pyogenes isolates recovered from colonized and infected children. The ParC S79A substitution was frequent and associated with the emm6/sequence type 382 (emm6/ST382) lineage. The ParC D83G substitution was detected in two isolates (emm5/ST99 and emm28/ST52 lineages). One isolate (emm89/ST101) had no quinolone resistance-determining region codon substitutions or other resistance mechanisms. Five of 66 isolates were levofloxacin resistant. Although fluoroquinolones are not used in children, they may be putative disseminators of fluoroquinolone-nonsusceptible strains in the community.Streptococcus pyogenes clinical isolates with reduced susceptibility to fluoroquinolones (1,3,8,14,16,18,27,29) or with high-level resistance (15,16,(23)(24)(25)28) have been described previously, and the reduced susceptibility to fluoroquinolones is mediated by point mutations in the quinolone resistancedetermining region (QRDR) of the parC gene (3, 16, 18) whereas high-level resistance has been associated with mutations in the QRDRs of both parC and gyrA genes (23, 28). To the best of our knowledge, there are no reports documenting the prevalence and characterization of fluoroquinolone-nonsusceptible S. pyogenes associated with asymptomatic colonization. Since 1999 and 2000, we have been collecting S. pyogenes isolates from pediatric patients from different clinical origins and from carriers for the surveillance of antimicrobial susceptibility and for the epidemiological characterization of the isolates. This study aimed to describe the prevalence of ciprofloxacin-nonsusceptible S. pyogenes isolates from colonized and infected Portuguese children from 1999 to 2006 and to characterize the associated clones and resistance mechanisms.Strains and antibiotic susceptibility. A total of 1,354 nonduplicated S. pyogenes isolates were collected from children in the Lisbon area in Portugal; 901 were associated with asymp-

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Section: Another Isolate Was Tetracycline Resistant Carrying Tet(msupporting

confidence: 81%

Emergence of Ciprofloxacin-Nonsusceptible Streptococcus pyogenes Isolates from Healthy Children and Pediatric Patients in Portugal

Pires

Ardanuy

Rolo

et al. 2010

Antimicrob Agents Chemother

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“…Several other substitutions have been described in the QRDRs, but only a few have been reported to confer resistance through in vitro studies: gyrA-E85K, gyrA-Q118K, gyrB-E474K, parC-A63T, parC-D83N, parE-E474K, and parE-D435N or -H (193,195,196). Other frequently described substitutions are K137N in parC and I460V in parE, which are commonly found in susceptible strains and appear not to contribute to fluoroquinolone resistance (197).…”

Section: Target Alterationmentioning

confidence: 99%

Biological and Epidemiological Features of Antibiotic-Resistant Streptococcus pneumoniae in Pre- and Post-Conjugate Vaccine Eras: a United States Perspective

et al. 2016

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SUMMARYStreptococcus pneumoniaeinflicts a huge disease burden as the leading cause of community-acquired pneumonia and meningitis. Soon after mainstream antibiotic usage, multiresistant pneumococcal clones emerged and disseminated worldwide. Resistant clones are generated through adaptation to antibiotic pressures imposed while naturally residing within the human upper respiratory tract. Here, a huge array of related commensal streptococcal strains transfers core genomic and accessory resistance determinants to the highly transformable pneumococcus. β-Lactam resistance is the hallmark of pneumococcal adaptability, requiring multiple independent recombination events that are traceable to nonpneumococcal origins and stably perpetuated in multiresistant clonal complexes. Pneumococcal strains with elevated MICs of β-lactams are most often resistant to additional antibiotics. Basic underlying mechanisms of most pneumococcal resistances have been identified, although new insights that increase our understanding are continually provided. Although all pneumococcal infections can be successfully treated with antibiotics, the available choices are limited for some strains. Invasive pneumococcal disease data compiled during 1998 to 2013 through the population-based Active Bacterial Core surveillance program (U.S. population base of 30,600,000) demonstrate that targeting prevalent capsular serotypes with conjugate vaccines (7-valent and 13-valent vaccines implemented in 2000 and 2010, respectively) is extremely effective in reducing resistant infections. Nonetheless, resistant non-vaccine-serotype clones continue to emerge and expand.

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“…Macrolide resistance has been clearly demonstrated to be associated to clinical treatment failure (Daneman et al, 2006). In contrast, for penicillin resistant pneumococci results of several studies were contradictory and the current view of most experts is, that only strains with a penicillin MIC >4 mg/l can cause treatment failure in CAP (Feldman, 2004;Klugman, 2002;Bauer et al, 2001) As a consequence, the breakpoint for resistance in pneumococcal pneumonia isolates has been recently increased to this MIC of 4 mg/l (Weinstein et al, 2009) Numerous recently published case reports have suggested an association between fluoroquinolone resistance and treatment failure (Fuller and Low, 2005;Pletz et al, 2005Pletz et al, , 2006a.…”

Section: Introductionmentioning

confidence: 99%

Low prevalence of fluoroquinolone resistant strains and resistance precursor strains in Streptococcus pneumoniae from patients with community-acquired pneumonia despite high fluoroquinolone usage

Pletz

Linden

Baum

et al. 2011

International Journal of Medical Microbiology

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Fluoroquinolone-resistantStreptococcus pneumoniae

Cited by 17 publications

References 10 publications

Emergence of Ciprofloxacin-Nonsusceptible Streptococcus pyogenes Isolates from Healthy Children and Pediatric Patients in Portugal

Emergence of Ciprofloxacin-Nonsusceptible Streptococcus pyogenes Isolates from Healthy Children and Pediatric Patients in Portugal

Biological and Epidemiological Features of Antibiotic-Resistant Streptococcus pneumoniae in Pre- and Post-Conjugate Vaccine Eras: a United States Perspective

Low prevalence of fluoroquinolone resistant strains and resistance precursor strains in Streptococcus pneumoniae from patients with community-acquired pneumonia despite high fluoroquinolone usage

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