Molecular Typing of<i>Streptococcus pneumoniae</i>in Northeastern Romania: Unique Clones of<i>S. pneumoniae</i>Isolated from Children Hospitalized for Infections and from Healthy and Human Immunodeficiency Virus–Infected Children in the Community

Porat, Nurith; Leibovitz, Eugene; Dagan, Ron; Coman, Gabriela; Sfartz, S; Peled, Nechama; Trefler, Ronit; Tomasz, Alexander

doi:10.1086/315316

Cited by 15 publications

(12 citation statements)

References 28 publications

(26 reference statements)

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“…Entre os sorotipos identificados em nossa amostra, encontravam-se aqueles descritos como sorotipos pediá-tricos e aqueles que comumente causam doença invasiva em crianças: 6, 14, 19 e 23 11,[20][21][22] . Com estes sorotipos identificados (6A, 6B, 7C, 9V, 11A, 13, 14, 15A, 16F, 18C, 19B, 19F, 23B, 23F, 34), podemos estimar que a vacina 7 valente poderia conferir uma proteção ao redor de 85,7% para nossa população.…”

Section: Discussionunclassified

Nasopharyngeal colonization with Streptococcus pneumoniae in children infected with human immunodeficiency virus

Cardoso

Cervi²,

Cintra³

et al. 2006

J Pediatr (Rio J)

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Objectives: To determine the prevalence of pneumococcus colonization among HIV-infected outpatients aged 0 to 18 years. To determine the resistance to penicillin of the microorganisms observed, to identify their serotypes, and to determine whether there are associations between known risk factors and colonization in this group. Material and method:This was an observational and crosssectional study in which nasopharynx swabs were collected from 112 children on the occasion of their monthly appointments and a questionnaire applied to the mothers. The material collected was processed at the microbiology laboratory of the hospital in accordance with National Committee for Clinical Laboratory Standards (NCCLS) regulations and serotyping was performed at the Centers for Diseases Control and Prevention (CDC). Data were analyzed statistically using the chi-square test and with univariate and multivariate analysis with multiple logistic regression. Results:The prevalence rate of nasopharyngeal colonization by pneumococci was 28.6%, with a 15.6% rate of resistance to penicillin (6.2% intermediate resistance and 9.4% full resistance). The serotypes identified were 6A, 6B, 7C, 9V, 11A, 13, 14, 15A, 16F, 18C, 19B, 19F, 23B, 23F, and 34. In this population there were no associations between pneumococcal colonization and the risk factors studied. Conclusions:The prevalence of pneumococcal colonization among HIV-infected children at our service was not higher than prevalence rates observed in healthy children and reported in the literature.

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Section: Discussionunclassified

Nasopharyngeal colonization with Streptococcus pneumoniae in children infected with human immunodeficiency virus

Cardoso

Cervi²,

Cintra³

et al. 2006

J Pediatr (Rio J)

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“…Streptococcus pneumoniae carrying tet(M) but susceptible to tetracyclines have previously been described, however the mechanisms and significance of this phenomenon are still unknown [26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Evidence for tetracycline resistance determinant tet(M) allele replacement in a Streptococcus pneumoniae population of limited geographical origin

Dzierżanowska-Fangrat

Semczuk

Górska

et al. 2006

International Journal of Antimicrobial Agents

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“…Susceptibility to tetracycline has apparently been observed in tet(M)-positive isolates of the largest of national epidemic penicillin-nonsusceptible S. pneumoniae clones identified in the United States in 1996 and 1997 (7) and Romania (32), and intermediate susceptibility (MICs, 2 to 4 mg/liter) has been observed in some Italian isolates of the Spanish 23F clone (19). However, by routine susceptibility testing, resistance to tetracycline is evaluated without any induction of resistance, and it is therefore possible that some tetracycline-resistant S. pneumoniae strains may have been misidentified as susceptible.…”

Section: Discussionmentioning

confidence: 99%

Genetic Diversity of the tet (M) Gene in Tetracycline-Resistant Clonal Lineages of Streptococcus pneumoniae

Doherty

Trzciński

Pickerill

et al. 2000

Antimicrob Agents Chemother

116

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The aim of the present study was to examine the stability and evolution of tet(M)-mediated resistance to tetracyclines among members of different clonal lineages of Streptococcus pneumoniae. Thirty-two tetracyclineresistant isolates representing three national (Spanish serotype 14, Spanish serotype 15, and Polish serotype 23F) and one international (Spanish serotype 23F) multidrug-resistant epidemic clones were all found to be tet(M) positive and tet(O), tet(K), and tet(L) negative. These isolates all carried the integrase gene, int, which is associated with the Tn1545-Tn916 family of conjugative transposons. High-resolution restriction analysis of tet(M) products identified six alleles, tet(M)1 to tet(M)6: tet(M)1 to tet(M)3 and tet(M)5 in isolates of the Spanish serotype 14 clone, tet(M)4 in both the Spanish serotype 15 and 23F clones, and tet(M)6, the most divergent allele, in the Polish 23F clone. This indicates that tet(M) variation can occur at the inter-and intraclone levels in pneumococci. Two alleles of int were identified, with int1 being found in all isolates apart from members of the international Spanish 23F clone, which carried int2. Susceptibility to tetracycline, doxycycline, and minocycline was evaluated for all isolates with or without preincubation in the presence of subinhibitory concentrations of tetracyclines. Resistance to tetracyclines was found to be inducible in isolates of all clones; however, the strongest induction was observed in the Spanish serotype 15 and 23F clones carrying tet(M)4. Tetracycline was found to be the strongest inducer of resistance, and minocycline was found to be the weakest inducer of resistance.The gram-positive pathogen Streptococcus pneumoniae (the pneumococcus) is a major cause of pneumonia, otitis media, and meningitis (12). The evolution and broad global distribution of multiple antibiotic resistance determinants in bacteria have resulted in a situation in which pneumococci are commonly resistant to penicillin, the broad-spectrum cephalosporins, macrolides, lincosamides, co-trimoxazole, chloramphenicol, and tetracyclines, as well as rifampin (11), sulphonamides (42), and fluoroquinolones (13,24,30), making the treatment of serious pneumococcal disease increasingly difficult (17,22). The transformable nature of S. pneumoniae (which has played an important role, along with point mutations) in the evolution of resistance [1,4,11,13,24,30] has in no small part also led to a population structure characterized by free genetic exchange, punctuated by clonal expansion of successful variants. The best studied of these are the Spanish 23F, Spanish 6B, and French/ Spanish 9V14 multidrug-resistant clones that have now spread intercontinentally (see reference 10 for a recent review).One class of antimicrobial agents found most often in clinical use is the tetracyclines, broad-spectrum bacteriostatic drugs shown to be active against pneumococci (33). In some European (9, 16, 23), Asian (35,36,41,47), and African (31, 52), countries lack of susceptibility to tetracyclines...

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Molecular Typing ofStreptococcus pneumoniaein Northeastern Romania: Unique Clones ofS. pneumoniaeIsolated from Children Hospitalized for Infections and from Healthy and Human Immunodeficiency Virus–Infected Children in the Community

Cited by 15 publications

References 28 publications

Nasopharyngeal colonization with Streptococcus pneumoniae in children infected with human immunodeficiency virus

Nasopharyngeal colonization with Streptococcus pneumoniae in children infected with human immunodeficiency virus

Evidence for tetracycline resistance determinant tet(M) allele replacement in a Streptococcus pneumoniae population of limited geographical origin

Genetic Diversity of the tet (M) Gene in Tetracycline-Resistant Clonal Lineages of Streptococcus pneumoniae

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