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Multidrug-resistant Streptococcus pneumoniae in Poland: identification of emerging clones
K Overweg1, P W Hermans, K Trzcinski
1Department of Pediatrics, Sophia Children's Hospital, Erasmus University Rotterdam, 3000 DR Rotterdam, The Netherlands.
Abstract:
Penicillin resistance among Streptococcus pneumoniae isolates has rapidly emerged in Poland during the last decade and has reached prevalence levels of up to 14.4% in 1997. In order to investigate the nature of this increase, a molecular epidemiological analysis of non-penicillin-susceptible multidrug-resistant pneumococci isolated in 1995 and 1996 was conducted. Thirty-seven patients who suffered mainly from upper respiratory tract infections and pneumococcal pneumonia were enrolled in this study. The medical centers to which the patients were admitted were located in 16 Polish towns across the country. Eight distinct BOX PCR types were observed, representing 14 subtypes. Restriction fragment end labeling (RFEL) analysis divided the pneumococcal strains into 16 distinct types. By combining the BOX PCR and RFEL data, four genetically distinct clusters of strains were identified. Two clusters represented the genetic clones 23F and 9V, which have recently emerged all over the world. The two other genetic clusters, which represented serotypes 23F and 6B, clearly predominated in the analyzed collection of Polish non-penicillin-susceptible pneumococcal strains. Since the latter clusters did not match any of the 133 RFEL types of non-penicillin-susceptible pneumococci collected in 15 other countries, their Polish clonal origin is most likely.
Insights
Penicillin resistance in Streptococcus pneumoniae is rising in Poland. Molecular analysis revealed distinct genetic clusters, suggesting a likely Polish origin for some resistant strains.
Area of Science:
- Microbiology
- Epidemiology
- Molecular Biology
Background:
- Penicillin resistance in Streptococcus pneumoniae has increased significantly in Poland, reaching 14.4% by 1997.
- Multidrug-resistant pneumococci pose a growing public health concern.
Purpose of the Study:
- To investigate the molecular epidemiology of non-penicillin-susceptible, multidrug-resistant pneumococci in Poland.
- To identify the genetic relatedness and potential origin of these resistant strains.
Main Methods:
- Molecular epidemiological analysis of 37 Streptococcus pneumoniae isolates from 1995-1996.
- Utilized BOX PCR and Restriction Fragment End Labeling (RFEL) for strain typing.
- Compared Polish isolates with international collections.
Main Results:
- Identified eight BOX PCR types and 16 RFEL types, resulting in four distinct genetic clusters.
- Two clusters corresponded to globally emerging clones (23F and 9V).
- Two predominant clusters (serotypes 23F and 6B) showed no match with international strains, suggesting a local origin.
Conclusions:
- The study identified specific genetic clusters of resistant pneumococci in Poland.
- Evidence suggests a likely Polish clonal origin for certain prevalent resistant serotypes (23F and 6B).
- Highlights the importance of ongoing molecular surveillance of antibiotic resistance.