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Characterization of German penicillin non-susceptible serotype 23F pneumococci using multilocus sequence typing
Ralf René Reinert1, Stefanie Muckel1, Adnan Al-Lahham1
1Institute of Medical Microbiology, National Reference Center for Streptococci, University Hospital, D-52057 Aachen, Germany 2Department of Infectious Disease Epidemiology, Imperial College School of Medicine, St Mary's Campus, London W2 1PG, UK 3Department of Microbiology, University of Oxford, and Department of Public Health & Primary Care, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK 4Institute of Microbiology, University of Kaiserslautern, Germany.
Abstract:
Three nationwide multicentre studies (n = 5071) showed an increase in antibiotic resistance in pneumococci in Germany. Serotype 23F was the predominant serotype (n = 45, 22.4 %), followed by 6B (n = 30, 14.9 %) and 9V (n = 19, 9.5 %). Multilocus sequence typing was used to characterize 45 serotype 23F strains with reduced penicillin susceptibility. The Spanish(23F)-1 clone [profile 4-4-2-4-4-1-1, sequence type (ST) 81] contributes significantly to the emergence of penicillin resistance in Germany (n = 21, 46.7 % of all penicillin non-susceptible serotype 23F isolates). Isolates of ST 277 (profile 7-13-8-6-6-12-8), which has been found previously in the Netherlands, are also observed, particularly in western Germany (n = 8, 17.8 %). A high proportion of strains (n = 11, 24.4 %) have sequence types that have not been reported to date from other countries (STs 353-362). The major penicillin-resistant clones are present in Germany, a country with relatively low levels of beta-lactam resistance.