Penicillin‐Resistant<i>Streptococcus pneumoniae</i>in the Netherlands: Results of a 1‐Year Molecular Epidemiologic Survey

Hermans, Peter W. M.; Sluijter, Marcel; Elzenaar, Kees; Veen, Ans van; Schonkeren, Joris; Nooren, Floortje M.; Leeuwen, W. J. Van; Neeling, Albert J. de; Klingeren, B. Van; Verbrugh, Henri A.; Groot, Ronald de

doi:10.1086/516474

Cited by 68 publications

(53 citation statements)

References 36 publications

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“…Susceptibility testing of 919 of the 921 pneumococcal isolates was performed for penicillin, cotrimoxazole, tetracycline, erythromycin, rifampin, vancomycin, cefotaxime, and ciprofloxacin. In agreement with previous studies performed in The Netherlands, the overall resistance is low (14% of the isolates) compared to that found in other European countries (4,13,14,17,18). Penicillin resistance was found rarely in our study.…”

Section: Discussionsupporting

confidence: 92%

Molecular Epidemiology of Pneumococcal Colonization in Response to Pneumococcal Conjugate Vaccination in Children with Recurrent Acute Otitis Media

et al. 2005

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A randomized double-blind trial with a 7-valent pneumococcal conjugate vaccine was conducted in The Netherlands among 383 children, aged 1 to 7 years, with a history of recurrent acute otitis media. No effect of vaccination on the pneumococcal colonization rate was found. However, a shift in serotype distribution was clearly observed (R. Veenhoven et al., Lancet 361:2189-2195, 2003). We investigated the molecular epidemiology of 921 pneumococcal isolates retrieved from both the pneumococcal vaccine (PV) and control vaccine (CV) groups during the vaccination study. Within individuals a high turnover rate of pneumococcal restriction fragment end labeling genotypes, which was unaffected by vaccination, was observed. Comparison of the genetic structures before and after completion of the vaccination scheme revealed that, despite a shift in serotypes, there was clustering of 70% of the pneumococcal populations. The remaining isolates (30%) were equally observed in the PV and CV groups. In addition, the degree of genetic clustering was unaffected by vaccination. However, within the population genetic structure, nonvaccine serotype clusters with the serotypes 11, 15, and 23B became predominant over vaccine-type clusters after vaccination. Finally, overall pneumococcal resistance was low (14%), and, albeit not significant, a reduction in pneumococcal resistance as a result of pneumococcal vaccination was observed. Molecular surveillance of colonization in Dutch children shows no effect of pneumococcal conjugate vaccination on the degree of genetic clustering and the genetic structure of the pneumococcal population. However, within the genetic pneumococcal population structure, a clear shift toward nonvaccine serotype clusters was observed.

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Section: Discussionsupporting

confidence: 92%

Molecular Epidemiology of Pneumococcal Colonization in Response to Pneumococcal Conjugate Vaccination in Children with Recurrent Acute Otitis Media

et al. 2005

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“…For comparative pbp fingerprinting purposes, DNA from a strain representative of each of RFLP fingerprint obtained was sent to M. Sluijter, Erasmus University, Rotterdam, The Netherlands. Therefore, in the present study the number assignments used to differentiate pbp gene fingerprints are arbitrary but correspond to the numbers and RFLP fingerprints of the pbp fingerprinting system documented previously (8,19,37,38,43). Three distinct patterns were observed with the pbp1A genes; these were designated A1, A2, and A4.…”

Section: Resultsmentioning

confidence: 90%

Penicillin Susceptibility and Epidemiological Typing of Invasive Pneumococcal Isolates in the Republic of Ireland

et al. 2003

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A national study was undertaken to investigate the incidence of invasive pneumococcal disease in the Republic of Ireland and to examine the associated isolates. In 1999, 144 S. pneumoniae isolates, all recovered from cases of invasive disease, were received from 12 microbiology laboratories. The incidence of invasive pneumococcal disease was estimated to be 6.6/100,000 population. All isolates were analyzed for serotype, penicillin susceptibility, chromosomal relatedness (by using pulsed-field gel electrophoresis [PFGE]), and penicillin-binding protein (pbp) fingerprinting. Several findings of note were observed regarding the pneumococcal population in Ireland. First, isolates of 25 different serotypes were represented, with serotypes 14, 9V, 8, 5, 4, and 3 being the most common. This finding, together with the pbp fingerprinting and PFGE typing results, indicated the clonal spread of strains of these serotypes in Ireland. Second, 27 (18.7%) isolates had reduced susceptibility to penicillin, and 74% of these were serotype 9V. Of these, 80% appeared to belong to the same clone. This could suggest the spread of the international Spanish/French 9V penicillin-resistant clone into Ireland. Third, nine different pbp genotypes were identified, four of which were new. Two pbp genotypes accounted for the majority of isolates dividing them according to their penicillin susceptibility status but irrespective of serotype and PFGE type. This is strong evidence for the occurrence of horizontal transfer of pbp genes between strains, observed with both penicillin-susceptible and penicillin-nonsusceptible isolates. Fourth, there was evidence of serotype transformation since isolates, indistinguishable by pbp fingerprinting and PFGE typing, expressed different capsular types.

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“…Antibiotic resistance rates among respiratory pathogens in The Netherlands are still quite low, although only limited data from the general population or from patients with meningitis (9,12) are available. The prevalence of beta-lactamase production among H. influenzae isolates from sputum samples taken in The Netherlands was only 6.3% in a recent study (21); these samples originate mainly from elderly patients with chronic pulmonary diseases.…”

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confidence: 99%

Nasopharyngeal Carriage of Potential Bacterial Pathogens Related to Day Care Attendance, with Special Reference to the Molecular Epidemiology of Haemophilus influenzae

Peerbooms

Engelen²,

Stokman³

et al. 2002

J Clin Microbiol

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Nasopharyngeal carriage of Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis was studied in 259 children attending day care centers (DCC) in Amsterdam, The Netherlands, and in 276 control children. The DCC children were sampled a second time after 4 weeks. Carriage rates for DCC children and controls were 58 and 37% for S. pneumoniae, 37 and 11% for H. influenzae, and 80 and 48% for M. catarrhalis, respectively. No increased antibiotic resistance rates were found in strains isolated from DCC children. All H. influenzae isolates were typed by random amplified polymorphic DNA (RAPD) analysis. Evidence for frequent transmission of H. influenzae strains within DCC was found. In the control group only two isolates (4%) displayed identical RAPD types versus 38% of strains from DCC children. Colonization with H. influenzae appeared to be short-lived in these children; more than half of the children harboring H. influenzae in the first sample were negative in the second sample, whereas most children still positive in the second sample had a different genotype than in the first sample. Of the newly acquired strains in the second sample, 40% were identical to a strain that had been found in a child in the same DCC in the first sample. DCC are to be considered epidemiological niches with a high potential for the spread of pathogenic microorganisms.

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Penicillin‐ResistantStreptococcus pneumoniaein the Netherlands: Results of a 1‐Year Molecular Epidemiologic Survey

Cited by 68 publications

References 36 publications

Molecular Epidemiology of Pneumococcal Colonization in Response to Pneumococcal Conjugate Vaccination in Children with Recurrent Acute Otitis Media

Molecular Epidemiology of Pneumococcal Colonization in Response to Pneumococcal Conjugate Vaccination in Children with Recurrent Acute Otitis Media

Penicillin Susceptibility and Epidemiological Typing of Invasive Pneumococcal Isolates in the Republic of Ireland

Nasopharyngeal Carriage of Potential Bacterial Pathogens Related to Day Care Attendance, with Special Reference to the Molecular Epidemiology of Haemophilus influenzae

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