The Molecular Epidemiology of Streptococcus pneumoniae with Quinolone Resistance Mutations

Background. The purpose of this study was to determine the prevalence of fluoroquinolone resistance and quinolone resistance—determining region (QRDR) mutations among Streptococcus pneumoniae isolates in the United States during the period of 2001–2002. A second objective was to examine the genetic...

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Bibliographic Details
Published in:Clinical infectious diseases 2005-01, Vol.40 (2), p.225-235
Main Authors: Richter, S. S., Heilmann, K. P., Beekmann, S. E., Miller, N. J., Rice, C. L., Doern, G. V.
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - pharmacology
Antibacterial agents
Antibiotics
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antimicrobials
Bacterial diseases
Biological and medical sciences
Ciprofloxacin - pharmacology
DNA Gyrase - genetics
DNA Topoisomerase IV - genetics
Drug resistance
Drug Resistance, Bacterial
Epidemiology
Fluoroquinolones
Genetic mutation
Genetic relationships
Human bacterial diseases
Humans
Infectious diseases
Levofloxacin
Major Articles
Medical sciences
Microbial Sensitivity Tests
Molecular epidemiology
Mutation
Ofloxacin - pharmacology
Penicillin
Pharmacology. Drug treatments
Pneumococcal Infections - drug therapy
Pneumococcal Infections - epidemiology
Pneumococcal Infections - microbiology
Population Surveillance
Quinolones
Serotyping
Staphylococcal infections, streptococcal infections, pneumococcal infections
Streptococcus pneumoniae
Streptococcus pneumoniae - drug effects
Streptococcus pneumoniae - genetics
Surveillance
Time Factors
United States
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Summary:Background. The purpose of this study was to determine the prevalence of fluoroquinolone resistance and quinolone resistance—determining region (QRDR) mutations among Streptococcus pneumoniae isolates in the United States during the period of 2001–2002. A second objective was to examine the genetic relatedness of pneumococcal isolates with parC and/or gyrA mutations during the period of 1994–2002. Methods. Susceptibility testing was performed for 1902 S. pneumoniae isolates collected in the United States during the period of 2001–2002. On the basis of the minimum inhibitory concentration (MIC) of ciprofloxacin, 146 isolates were selected from the 2001–2002 study for QRDR analysis of parC, parE, gyrA, and gyrB genes. The genetic relatedness of isolates with parC and/or gyrA mutations from 2001–2002 (n = 55) and from 3 US surveillance studies conducted during 1994–2000 (n = 56) was determined by pulsed-field gel electrophoresis (PFGE). Results. Between 1999–2000 and 2001–2002, there was a 2-fold increase in the rate of ciprofloxacin resistance (MIC, ⩾4 µg/mL), from 1.2% to 2.7%, and in the rate of levofloxacin nonsusceptibility (MIC, ⩾4 µg/mL), from 0.6% to 1.3%. The 111 isolates with parC and/or gyrA mutations were assigned to 48 different PFGE types. Forty-four isolates (40%) belonged to 8 PFGE types that were closely related to widespread clones. Fifteen of the 43 levofloxacin-nonsusceptible pneumococci (LNSP) belonged to 4 PFGE types that were closely related to major clones (Spain23F-1 [n = 6]; Spain6B-2 [n = 5], Taiwan19F-14 [n = 2], and Tennessee23F-4 [n = 2]). Conclusion. The population of fluoroquinolone-resistant S. pneumoniae in the United States has increased but remains genetically diverse. However, 35% of LNSP were related to widespread pneumococcal clones, increasing the potential for the rapid spread of quinolone resistance in this species.
ISSN:1058-4838
1537-6591
DOI:10.1086/426817