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Journal of Clinical Microbiology, March 1999, p. 638-648, Vol. 37, No. 3
The Rockefeller University, New York, New
York 10021
Received 20 July 1998/Returned for modification 3 September
1998/Accepted 17 November 1998
As part of an ongoing surveillance program of antibiotic-resistant
Streptococcus pneumoniae in Sofia, Bulgaria, 120 penicillin-resistant strains (PRSP) (most of them recovered from
children hospitalized with pneumococcal disease) were analyzed by
microbiological and molecular methods. Several unique features of this
collection are of particular interest. (i) Most isolates (112 of 120)
were also resistant to trimethoprim-sulfamethoxazole (SXT) (97 of
120 isolates, or 80%), and over 70% (86 of 120) of the isolates were resistant to at least three antibiotics in addition to penicillin. (ii)
Close to 80% of all isolates were represented by large clusters of
bacteria, each with a unique serotype, antibiotype, and chromosomal macrorestriction pattern (determined by pulsed-field gel
electrophoresis), as well as unique restriction fragmentation length
polymorphisms of the penicillin-binding protein genes
pbp1a, pbp2x, and pbp2b. (iii) A
large proportion (45 of 120, or 38%) of the strains belonged to two
internationally spread epidemic clones of S. pneumoniae, the first expressing capsular type 23F and the second
expressing serotype 9. (iv) A unique Bulgarian cluster composed of
eight serotype 19F isolates was resistant to tetracycline, SXT,
cefotaxime, and extremely high levels of penicillin and
erythromycin. Nevertheless, this clone did not react with either
the erm or the mef DNA probes, and thus
the mechanism of macrolide resistance in this group of PRSP
remains to be elucidated.
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Molecular Characterization of
Penicillin-Resistant Streptococcus pneumoniae Isolates
from Bulgaria
and
*
Corresponding author. Mailing address: The Rockefeller
University, 1230 York Ave., New York, NY 10021. Phone: (212) 327-8277. Fax: (212) 327-8688. E-mail:
tomasz{at}rockvax.rockefeller.edu.
Present address: Medical University Hospital for Infectious
Diseases, Sofia 1431, Bulgaria.
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