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Persistence and complex evolution of fluoroquinolone-resistant Streptococcus pneumoniae clone
Emerging Infectious Diseases
|April 23, 2014
Summary
A rare, multidrug-resistant Streptococcus pneumoniae clone persisted for five years in an Israeli post-acute care facility. This highlights long-term care facilities as reservoirs for resistant bacteria, even with infection control measures.
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Multidrug-resistant Streptococcus pneumoniae (MDRSP) outbreaks in healthcare settings are infrequent.
- Long-term care facilities (LTCFs) can act as reservoirs for antibiotic-resistant bacteria.
Purpose of the Study:
- To investigate the persistent transmission of a fluoroquinolone-resistant S. pneumoniae clone in an Israeli post-acute care facility.
- To understand the genetic mechanisms and duration of spread for this resistant clone.
Main Methods:
- Longitudinal surveillance of S. pneumoniae isolates from a post-acute care facility between 2006 and 2011.
- Molecular typing and antimicrobial susceptibility testing of identified S. pneumoniae clones.
- Analysis of genetic mutations associated with fluoroquinolone resistance and capsular switching.
Main Results:
- A single clone of fluoroquinolone-resistant S. pneumoniae demonstrated persistent transmission over a five-year period (2006-2011).
- Despite mandatory vaccination policies and fluoroquinolone restrictions, the clone continued to spread.
- Genetic analysis revealed capsular switching and multiple antimicrobial nonsusceptibility mutations within this specific clone.
Conclusions:
- Long-term care facilities can serve as significant reservoirs for the sustained transmission of multidrug-resistant streptococci.
- The persistence of this MDRSP clone underscores the challenges in controlling resistant bacterial infections in healthcare settings.
- Continuous monitoring and targeted interventions are crucial for managing MDRSP in vulnerable populations within LTCFs.
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