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Journal of Clinical Microbiology, December 2000, p. 4361-4366, Vol. 38, No. 12
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Molecular Epidemiology of Penicillin-Nonsusceptible Streptococcus pneumoniae among Children in Greece

Debby Bogaert,1 George A. Syrogiannopoulos,2,* Ioanna N. Grivea,2 Ronald de Groot,1 Nicholas G. Beratis,2 and Peter W. M. Hermans1,*

Department of Pediatrics, Sophia Children's Hospital, Erasmus University Rotterdam, Rotterdam, The Netherlands,1 and Department of Pediatrics, General University Hospital, University of Patras, School of Medicine, Patras, Greece2

Received 10 July 2000/Returned for modification 28 August 2000/Accepted 25 September 2000

A total of 145 penicillin-nonsusceptible Streptococcus pneumoniae strains were isolated from young carriers in Greece and analyzed by antibiotic susceptibility testing, serotyping, restriction fragment end labeling (RFEL), and penicillin-binding protein (PBP) genotyping. The serotypes 23A and 23F (54%), 19A and 19F (25%), 9V (5%), 15A, 15B, and 15C (4%), 6A and 6B (4%), and 21 (4%) were most prevalent in this collection. Fifty-three distinct RFEL types were identified. Sixteen different RFEL clusters, harboring 2 to 32 strains each, accounted for 82% of all strains. Eight of these genetic clusters representing 60% of the strains were previously identified in other countries. A predominant lineage of 66 strains (46%) harboring five RFEL types and the serotypes 19F and 23F was closely related to the pandemic clone Spain23F-1 (genetic relatedness of >= 85%). Another lineage, representing 11 strains, showed close genetic relatedness to the pandemic clone France9V-3. Another lineage of 8 serotype 21 strains was Greece specific since the RFEL types were not observed in an international collection of 193 genotypes from 16 different countries. Characterization of the PBP genes pbp1a, pbp2b, and pbp2x revealed 20 distinct PBP genotypes of which PBP type 1-1-1, initially observed in the pandemic clones 23F and 9V, was predominantly present in 11 RFEL types in this Greek collection of penicillin-nonsusceptible strains (55%). Sixteen PBP types covering 52 strains (36%) were Greece specific. This study underlines the strong contribution of penicillin-resistant international clones to the prevalence and spread of penicillin-nonsusceptible pneumococci among young children in Greece.

* Corresponding author. Mailing address for Peter W. M. Hermans: Laboratory of Pediatrics, Rm. Ee1500, 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. Mailing address for George A. Syrogiannopoulos: Department of Pediatrics, University of Patras, School of Medicine, 26 500 Rion, Patras, Greece. Phone: 61-993948. Fax: 61-994533. E-mail: syrogian{at}med.upatras.gr.

Journal of Clinical Microbiology, December 2000, p. 4361-4366, Vol. 38, No. 12
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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