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Journal of Clinical Microbiology, June 1999, p. 1832-1838, Vol. 37, No. 6
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Nasopharyngeal Carriage of Penicillin-Resistant Streptococcus pneumoniae among Children with Acute Respiratory Tract Infections in Thailand: a Molecular Epidemiological Survey

Surang Dejsirilert,1 Karin Overweg,2 Marcel Sluijter,2 Leelawadee Saengsuk,1 Mike Gratten,3 Takayuki Ezaki,4 and Peter W. M. Hermans2,*

National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand1; Department of Pediatrics, Sophia Children's Hospital, Erasmus University Rotterdam, 3000 DR Rotterdam, The Netherlands2; Laboratory of Microbiology and Pathology, Queensland Health, Brisbane, Australia3; and Department of Microbiology, Gifu University School of Medicine, Gifu, Japan4

Received 1 December 1998/Returned for modification 21 January 1999/Accepted 18 March 1999

The prevalence of penicillin-resistant Streptococcus pneumoniae in Thailand has dramatically increased over the last decade. During a national survey, which was conducted from 1992 to 1994, 37.2% of the pneumococci isolated from the nasopharynges of children with acute respiratory tract infections were penicillin resistant (MIC, >= 0.1 µg/ml). In order to investigate the prevalence and clonal relatedness of nasopharyngeal carriage of penicillin-resistant S. pneumoniae in Thailand, a molecular epidemiological survey was undertaken. To this end, 53 penicillin-resistant pneumococcal isolates from children who suffered from acute respiratory tract infections and who originated from five distinct regions of the country were characterized in detail. DNA fingerprint analysis demonstrated 13 clusters, i.e., genotypes shared by two or more strains, and 14 unique genotypes. The cluster size varied from 2 (nine clusters) to 11 strains (one cluster). Six of the 13 restriction fragment end labeling clusters consisted of two or more distinct serotypes, indicating frequent horizontal transfer of capsular genes. Geographical distribution of the genotypes among the five regions of Thailand demonstrated that only four genetic clusters were restricted to single areas of the country, whereas the other nine clusters represented isolates collected in two or more districts. These observations demonstrate that the majority of the genetic clusters are spread throughout the country. The most predominant genetic cluster, representing 21% of the isolates, was identical to the Spanish pandemic clone 23F. In addition, the second largest cluster matched the Spanish-French international clone 9V. These data indicate that the genetic clones 23F and 9V, which are widely spread throughout the world, are the most predominant multidrug-resistant pneumococcal clones in Thailand. Therefore, we conclude that these pandemic clones are primarily responsible for the increase in the prevalence of pneumococcal penicillin resistance in Thailand.

* Corresponding author. Mailing address: Laboratory of Pediatrics, Room Ee 1500, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. Phone: 31-10-4088224. Fax: 31-10-4089486. E-mail: hermans{at}kgk.fgg.eur.nl.

Journal of Clinical Microbiology, June 1999, p. 1832-1838, Vol. 37, No. 6
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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