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Spread of Meropenem-Resistant Streptococcus pneumoniae Serotype 15A-ST63 Clone in Japan, 2012-2014

Satoshi Nakano, Takao Fujisawa, Yutaka Ito

    Emerging Infectious Diseases
    |January 20, 2018
    PubMed

    Insights

    Meropenem-resistant Streptococcus pneumoniae serotype 15A-ST63 strains emerged in Japan. Resistance appears linked to pbp1a gene recombination, with implications for global health as this strain is not covered by current vaccines.

    Area of Science:

    • Microbiology
    • Genomics
    • Vaccinology

    Background:

    • Increased incidence of meropenem-resistant Streptococcus pneumoniae serotype 15A-ST63 strains observed in Japan post-vaccine introduction.
    • Serotype 15A is not covered by the 13-valent pneumococcal conjugate vaccine (PCV13).

    Purpose of the Study:

    • To characterize the meropenem-resistant serotype 15A-ST63 pneumococcal clone.
    • To investigate the genetic basis of meropenem resistance in these strains.
    • To assess the potential for global spread.

    Main Methods:

    • Whole-genome sequencing of Japanese isolates.
    • Comparative genomic analysis with international clones (UK, US, Canada).
    • Recombination site prediction analysis.
    • Detailed analysis of penicillin-binding protein genes (pbp1a, pbp2b).

    Main Results:

    • Japanese meropenem-resistant serotype 15A-ST63 strains originated from susceptible strains within Japan.
    • Recombination in pbp1a and pbp2b regions was identified in resistant strains.
    • Meropenem resistance is strongly associated with pbp1a recombination.
    • The identified pbp1a gene is identical to that found in multidrug-resistant serotype 19A-ST320 pneumococci prevalent in the US.

    Conclusions:

    • The emergence of meropenem resistance in serotype 15A-ST63 pneumococci in Japan is driven by pbp1a recombination.
    • The genetic similarity to successful international clones raises concerns about potential global dissemination.
    • The lack of serotype 15A coverage in PCV13 necessitates enhanced surveillance and potential vaccine updates.
    Keywords:
    JapanPCV13PCV7ST63Streptococcus pneumoniaeantimicrobial resistancebacteriameropenem resistancepneumococcal conjugate vaccineserotype 15Avaccinationvaccines

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