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Journal of Clinical Microbiology, March 2005, p. 1294-1300, Vol. 43, No. 3
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.3.1294-1300.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Molecular Epidemiology of Macrolide-Resistant Streptococcus pneumoniae Isolates in Europe

Ralf René Reinert,1* Adrian Ringelstein,1 Mark van der Linden,1 Murat Yücel Cil,1 Adnan Al-Lahham,1 and Franz-Josef Schmitz2

Institute of Medical Microbiology, National Reference Center for Streptococci, University Hospital, Aachen, Germany,1 Eijkman-Winkler Institute for Medical Microbiology, University Hospital Utrecht, Utrecht, The Netherlands2

Received 26 July 2004/ Returned for modification 19 August 2004/ Accepted 7 October 2004

In many European countries, the level of pneumococcal resistance to macrolides has now passed the level of resistance to penicillin G. A total of 82 erythromycin A-resistant isolates of Streptococcus pneumoniae were collected by 11 laboratories in seven European countries. All of the isolates were tested for antimicrobial susceptibility, analyzed for clonal relatedness by multilocus sequence typing, and characterized for macrolide resistance genotypes. The prevalence of the macrolide resistance genotypes varied substantially between countries. In France (87.5% of all strains), Spain (77.3%), Switzerland (80%), and Poland (100%), strains were predominantly erm(B) positive, whereas higher levels of mef(A)-positive strains were reported from Greece (100%) and Germany (33.3%). Macrolide resistance was caused by the oligoclonal spread of some multilocus sequence types, but significant differences in clonal distribution were noted between France and Spain, countries from which high levels of macrolide resistance have been reported. Overall, sequence type 81 (Spain23F-1 clone) was by far the most widespread. The mainly erm(B)-positive serotype 14 clone (sequence type 143), first reported in Poland in the mid-1990s, is now widespread in France.

* Corresponding author. Mailing address: Institute for Medical Microbiology, National Reference Center for Streptococci, University Hospital, Pauwelsstr. 30, Aachen, Germany. Phone: 49 241 8089787. Fax: 49 241 8082483. E-mail: Reinert{at}rwth-aachen.de.

Journal of Clinical Microbiology, March 2005, p. 1294-1300, Vol. 43, No. 3
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.3.1294-1300.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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