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Journal of Clinical Microbiology, September 2003, p. 4178-4183, Vol. 41, No. 9
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.9.4178-4183.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Antimicrobial Susceptibility and Serotype Distribution of Streptococcus pneumoniae and Molecular Characterization of Multidrug-Resistant Serotype 19F, 6B, and 23F Pneumococci in Northern Thailand

Hiroshi Watanabe,1* Norichika Asoh,1 Kazuhiko Hoshino,1 Kiwao Watanabe,1 Kazunori Oishi,1 Weerayut Kositsakulchai,2 Tippaya Sanchai,2 Khemrassamee Kunsuikmengrai,2 Sumpun Kahintapong,2 Banyong Khantawa,3 Prasit Tharavichitkul,3 Thira Sirisanthana,4 and Tsuyoshi Nagatake1

Department of Internal Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan,1 Nakornping Hospital,2 Departments of Microbiology,3 Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand4

Received 30 April 2003/ Returned for modification 6 June 2003/ Accepted 26 June 2003

Penicillin-resistant Streptococcus pneumoniae is widely spread worldwide. Our study was undertaken to examine the susceptibility and serotypes of S. pneumoniae in northern Thailand. Ninety-three S. pneumoniae strains were isolated from 93 patients at Chiang Mai University Hospital, Chiang Mai, Thailand, from September 1999 to June 2000. The strains were isolated from sputum (n = 51), blood (n = 15), nasopharynges (n = 14), and other sources (e.g., pus, ears, ascites, and cerebrospinal fluid) (n = 13). Of the 93 isolates, 29 (31.2%) were susceptible, 24 (25.8%) showed intermediate resistance (MIC, 0.12 to 1.0 µg/ml), and 40 (43.0%) were fully resistant (MIC, >=2.0 µg/ml) to penicillin G. Seven (46.7%) from blood, 5 (35.7%) from nasopharynges, 15 (29.4%) from sputum, and 2 (15.4%) from other sources were susceptible isolates. Serotyping with the use of antiserum revealed differences in the predominant types that were susceptible (6A, 11A, and 19A), intermediately resistant (6B and 23F), and fully resistant (6B, 19F, and 23F). Molecular typing by pulsed-field gel electrophoresis of multidrug-resistant pneumococci showed four patterns (A, B, C, and D) for 16 isolates of serotype 19F, with pattern B being predominant (12 isolates). This finding was different from that with the Taiwan multidrug-resistant serotype 19F clone. Eleven isolates of serotype 6B all showed pattern E, and nine isolates of serotype 23F showed two patterns (F and G), with pattern F being predominant (seven isolates). This finding was similar to that with the Spanish multidrug-resistant serotype 23F clone. Our results indicated that the resistance of pneumococci to antibiotics in northern Thailand is progressing rapidly and that effort should be intensified to prevent any spread of pandemic multidrug-resistant serotypes 19F, 6B, and 23F.

* Corresponding author. Mailing address: Department of Internal Medicine, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan. Phone: 81 (95) 849-7842. Fax: 81 (95) 849-7843. Email: h-wata{at}net.nagasaki-u.ac.jp.

Journal of Clinical Microbiology, September 2003, p. 4178-4183, Vol. 41, No. 9
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.9.4178-4183.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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