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Journal of Clinical Microbiology, September 1999, p. 2834-2839, Vol. 37, No. 9
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Evidence of Clonal Dissemination of
Multidrug-Resistant Streptococcus pneumoniae in Hong
Kong
Margaret
Ip,1,*
Donald J.
Lyon,1
Raymond W. H.
Yung,2
Colin
Chan,1 and
Augustine
F. B.
Cheng1
Department of Microbiology, The Chinese
University of Hong Kong, Prince of Wales Hospital,
Shatin,1 and Pamela Youde Nethersole
Eastern Hospital,2 Hong Kong
Received 21 December 1998/Returned for modification 18 February
1999/Accepted 19 May 1999
The relationship between the phenotypic and genotypic
characteristics of 105 penicillin-intermediate or -resistant
Streptococcus pneumoniae isolates saved during 1994 to 1997 at the Prince of Wales Hospital and Pamela Youde Nethersole Eastern
Hospital, Hong Kong, was studied. The pbp genes for
penicillin-binding proteins 1a, 2b, and 2x for each isolate were
amplified by PCR, and the products were digested with restriction
enzymes HinfI and AluI. A combination of the
pulsed-field gel electrophoresis (PFGE) profiles, pbp
fingerprints, and phenotypic characteristics of capsular types and
antibiograms enabled these isolates to be divided into four major
groups. Seventy-four percent (78 of 105) of the strains, belonging to
serotypes 23F, 19F, and 14, showed indistinguishable pbp
fingerprint patterns (group A1, 1-1-1, 1-1-1), with PFGE patterns belonging to group A and its subtypes, suggesting that these strains were closely related. Eighty-three percent (65 of 78) of these isolates
were also resistant to tetracycline, erythromycin, chloramphenicol, and
trimethoprim. The type 23F isolates were indistinguishable from
representative strains of the Spanish 23F clone by these molecular
methods, indicating that these strains may be variants of the Spanish
23F clone. Serotype 6B accounted for 19% (20 of 105) of the isolates
with reduced penicillin susceptibility and was made up of variants
belonging to four different pbp fingerprint groups with the
PFGE pattern group B, the predominant group being indistinguishable
from that of the Spanish 6B clone. Other PFGE and fingerprint groups
were mainly obtained from penicillin-susceptible strains of various
serotypes. The results suggest that the rapid emergence of
drug-resistant S. pneumoniae in Hong Kong has been due to
the rapid dissemination of several successful clones.
*
Corresponding author. Mailing address: Department of
Microbiology, Chinese University of Hong Kong, Prince of Wales
Hospital, Shatin, New Territories, Hong Kong. Phone: (852) 2632 2306. Fax: (852) 2647 3227. E-mail: margaretip{at}cuhk.edu.hk.
Journal of Clinical Microbiology, September 1999, p. 2834-2839, Vol. 37, No. 9
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
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