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Journal of Clinical Microbiology, March 2005, p. 1285-1293, Vol. 43, No. 3
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.3.1285-1293.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Trends in Drug Resistance, Serotypes, and Molecular Types of Streptococcus pneumoniae Colonizing Preschool-Age Children Attending Day Care Centers in Lisbon, Portugal: a Summary of 4 Years of Annual Surveillance

S. Nunes,1 R. Sá-Leão,1 J. Carriço,2 C. R. Alves,1 R. Mato,1 A. Brito Avô,3 J. Saldanha,4 J. S. Almeida,2,5 I. Santos Sanches,1,6 and H. de Lencastre1,7*

Laboratório de Genética Molecular,1 Grupo de Biomatemática, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa,2 Centro de Saúde de Oeiras, Oeiras,3 Hospital de Santa Maria, Lisbon,4 Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Monte da Caparica, Portugal,6 Department of Biometry and Epidemiology, Medical University of South Carolina, Charleston, South Carolina,5 Laboratory of Microbiology, The Rockefeller University, New York, New York7

Received 14 September 2004/ Returned for modification 18 October 2004/ Accepted 5 November 2004

Of the nasopharyngeal cultures recovered from 942 day care center (DCC) attendees in Lisbon, Portugal, 591 (62%) yielded Streptococcus pneumoniae during a surveillance performed in February and March of 1999. Forty percent of the isolates were resistant to one or more antimicrobial agents. In particular, 2% were penicillin resistant and 20% had intermediate penicillin resistance. Multidrug resistance to macrolides, lincosamides, and tetracycline was the most frequent antibiotype (17% of all isolates). Serotyping and molecular typing by pulsed-field gel electrophoresis were performed for 202 out of 237 drug-resistant pneumococci (DRPn). The most frequent serotypes were 6B (26%), 14 (22%), 19F (16%), 23F (10%), and nontypeable (12%). The majority (67%) of the DRPn strains were representatives of nine international clones included in the Pneumococcal Molecular Epidemiology Network; eight of them had been detected in previous studies. Fourteen novel clones were identified, corresponding to 26% of the DRPn strains. The remaining 7% of the strains were local clones detected in our previous studies. Comparison with studies conducted since 1996 in Portuguese DCCs identified several trends: (i) the rate of DRPn frequency has fluctuated between 40 and 50%; (ii) the serotypes most frequently recovered have remained the same; (iii) nontypeable strains appear to be increasing in frequency; and (iv) a clone of serotype 33F emerged in 1999. Together, our observations highlight that the nasopharynxes of children in DCCs are a melting pot of successful DRPn clones that are important to study and monitor if we aim to gain a better understanding on the epidemiology of this pathogen.

* Corresponding author. Mailing address: The Rockefeller University, 1230 York Ave., New York, NY 10021. Phone: (212) 327-8278. Fax: (212) 327-8688. E-mail: lencash{at}rockefeller.edu.

Journal of Clinical Microbiology, March 2005, p. 1285-1293, Vol. 43, No. 3
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.3.1285-1293.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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