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Antimicrobial Agents and Chemotherapy, June 2008, p. 1964-1969, Vol. 52, No. 6
0066-4804/08/$08.00+0     doi:10.1128/AAC.01487-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Polyclonal Population Structure of Streptococcus pneumoniae Isolates in Spain Carrying mef and mef plus erm(B){triangledown}

Elia Gómez G. de la Pedrosa,1 María-Isabel Morosini,1 Mark van der Linden,2 Patricia Ruiz-Garbajosa,1 Juan Carlos Galán,1 Fernando Baquero,1 Ralf René Reinert,2 and Rafael Cantón1*

Servicio de Microbiología, Hospital Universitario Ramón y Cajal, and CIBER-ESP, Madrid, Spain,1 Institute for Medical Microbiology, National Reference Center for Streptococci, University Hospital (RWTH), Aachen, Germany2

Received 15 November 2007/ Returned for modification 4 February 2008/ Accepted 15 March 2008

The population structure (serotypes, pulsed-field gel electrophoresis [PFGE] types, and multilocus sequencing types) of 45 mef-positive Streptococcus pneumoniae isolates [carrying mef alone (n = 17) or with the erm(B) gene n = 28)] were studied. They were selected from among all erythromycin-resistant isolates (n = 244) obtained from a collection of 712 isolates recovered from different Spanish geographic locations in the prevaccination period from 1999 to 2003. The overall rates of resistance (according to the criteria of the CLSI) among the 45 mef-positive isolates were as follows: penicillin G, 82.2%; cefotaxime, 22.2%; clindamycin, 62.2%; and tetracycline, 68.8% [mainly in isolates carrying erm(B) plus mef(E); P < 0.001]. No levofloxacin or telithromycin resistance was found. Macrolide resistance phenotypes (as determined by the disk diffusion approximation test) were 37.7% for macrolide resistance [with all but one due to mef(E)] and 62.2% for constitutive macrolide-lincosamide-streptogramin B resistance [cMLSB; with all due to mef(E) plus erm(B)]. Serotypes 14 (22.2%), 6B (17.7%), 19A (13.3%), and 19F (11.1%) were predominant. Twenty-five different DNA patterns (PFGE types) were observed. Our mef-positive isolates were grouped (by eBURST analysis) into four clonal complexes (n = 18) and 19 singleton clones (n = 27). With the exception of clone Spain9V-3, all clonal complexes (clonal complexes 6B, Spain6B-2, and Sweden15A-25) and 73.6% of singleton clones carried both the erm(B) and the mef(E) genes. The international multiresistant clones Spain23F-1 and Poland6B-20 were represented as singleton clones. A high proportion of mef-positive S. pneumoniae isolates presented the erm(B) gene, with all isolates expressing the cMLSB phenotype. A polyclonal population structure was demonstrated within our Spanish mef-positive S. pneumoniae isolates, with few clonal complexes overrepresented within this collection.

* Corresponding author. Mailing address: Servicio de Microbiología, Hospital Universitario Ramón y Cajal, and CIBER-ESP, Madrid 28034, Spain. Phone: 34-91-3368330. Fax: 34-91-3368809. E-mail: rcanton.hrc{at}salud.madrid.org

{triangledown} Published ahead of print on 24 March 2008.

Antimicrobial Agents and Chemotherapy, June 2008, p. 1964-1969, Vol. 52, No. 6
0066-4804/08/$08.00+0     doi:10.1128/AAC.01487-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • de la Pedrosa, E. G. G., Baquero, F., Loza, E., Nadal-Serrano, J.-M., Fenoll, A., del Campo, R., Canton, R. (2009). High clonal diversity in erythromycin-resistant Streptococcus pneumoniae invasive isolates in Madrid, Spain (2000-07). J Antimicrob Chemother 64: 1165-1169 [Abstract] [Full Text]  


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