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Journal of Clinical Microbiology, April 2005, p. 1640-1645, Vol. 43, No. 4
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.4.1640-1645.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Clonal Dissemination of Macrolide-Resistant and Penicillin-Susceptible Serotype 3 and Penicillin-Resistant Taiwan 19F-14 and 23F-15 Streptococcus pneumoniae Isolates in Japan: a Pilot Surveillance Study

Kei Kasahara,^1* Koichi Maeda,² Keiichi Mikasa,³ Kenji Uno,¹ Ken Takahashi,¹ Mitsuru Konishi,³ Eiichiro Yoshimoto,³ Koichi Murakawa,⁴ Eiji Kita,⁵ and Hiroshi Kimura¹

Second Department of Internal Medicine,¹ Department of General Medicine,² Center for Infectious Diseases,³ Division of Central Clinical Laboratory,⁴ Department of Bacteriology, Nara Medical University, Nara, Japan⁵

Received 24 April 2004/ Returned for modification 5 July 2004/ Accepted 2 November 2004

Large-scale surveillance studies using molecular techniques such as pulsed-field gel electrophoresis (PFGE) have revealed that the spread of antibiotic-resistant pneumococci is due to clonal spread. However, in Japan, surveillance studies using such molecular techniques have never been done. Therefore, we conducted a pilot surveillance study to elucidate the present situation in Japan. Among the 145 isolates examined, the most prevalent serotype was type 19F (20%), for which most isolates were not susceptible to penicillin (86.2%) but were positive for the mef(A)/mef(E) gene (89.7%). The secondmost prevalent was serotype 3 (16.6%), for which most isolates were susceptible to penicillin (87.5%) and positive for the erm(B) gene (91.7%). PFGE analysis showed that both serotypes consisted mainly of clonally identical or related isolates and, in particular, 38% of the type 19F isolates were indistinguishable from or closely related to the Taiwan 19F-14 clone. In addition, some of the Japanese type 23F isolates with the erm(B) gene were indistinguishable from or related to the Taiwan 23F-15 clone as analyzed by PFGE. Based on the results of our pilot study performed in a single institution, it is likely that international antibiotic-resistant clones have already spread in Japan; therefore, a nationwide surveillance study should be urgently conducted.

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* Corresponding author. Mailing address: Second Department of Internal Medicine, Nara Medical University, 840 Shijo Cho, Kashihara City, Nara 634-8522, Japan. Phone: 81-744-22-3051. Fax: 81-744-29-0907. E-mail: kassan{at}naramed-u.ac.jp.

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Journal of Clinical Microbiology, April 2005, p. 1640-1645, Vol. 43, No. 4
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.4.1640-1645.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

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