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Volume 15, Number 6—June 2009

Research

Changes in Fluoroquinolone-Resistant Streptococcus pneumonia after 7-Valent Conjugate Vaccination, Spain

Adela G. de la CampaComments to Author , Carmen Ardanuy, Luz Balsalobre, Emilio Pérez-Trallero, Jose M. Marimón, Asunción Fenoll, and Josefina Liñares
Author affiliations: Instituto de Salud Carlos III, Madrid, Spain (A.G. de la Campa, L. Balsalobre, A. Fenoll); Ciber Enfermedades Respiratorias, Mallorca, Spain (A.G. de la Campa, C. Ardanuy, L. Balsalobre, E. Pérez-Trallero, J. M. Marimón, J. Liñares); Hospital Universitary de Bellvitge, Barcelona, Spain (C. Ardanuy, J. Liñares); Hospital Donostia, San Sebastian, Spain (E. Pérez-Trallero, J.M. Marimón)

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Table 2

Fluoroquinolone MICs of 30 low-level resistant Streptococcus pneumoniae isolates and 5 laboratory strains and amino acid changes in their DNA topoisomerase IV and gyrase genes, Spain, 2006*

No. isolates Amino acid substitution
Efflux phenotype†
parC
parE
gyrA
MIC, μg/mL
S79 S80 D83 D435 E474 S81 E85 CIP LVX MXF
1 4 1 0.12 None
3 4–8 2 0.5 CIP
1 –‡ –‡ –‡ –‡ –‡ –‡ –‡ 8 4 0.5 CIP
9 F 4–8 1–2 0.25–0.50 None
3 F 4–8 2 0.12–0.25 CIP
1 F –‡ –‡ 8 1 0.12 None
1 F‡ –‡* –‡ –‡ –‡ –‡ –‡ 8 2 0.12 CIP, LVX
5 Y 4–8 2 0.12–0.25 None
1 Y 4 2 0.25 CIP
1 N 16 4 0.5 None
1 N 4 2 0.12 CIP
1 Y 4 1 0.5 None
1 Y 8 2 0.5 CIP
1




N





8
2
0.12
None
Laboratory strains§
R6 0.5 0.25 0.12 None
R6CS80P P 2 1 0.25 None
T1 F 4 2 0.12 None
T1AS81V F V 32 32 4 None
T1AE85G F G 32 8 2 None

*par, topoisomerase gene; gyr, gyrase gene; CIP, ciprofloxacin; LVX, levofloxacin; MXF, moxifloxacin. Only changes involved in resistance are shown. –, no change. Additional amino acid changes not involved in resistance were parC D78N (1 isolate), parC K137 N (9), parC N91D (2 with mosaic parC genes), parE I460V (17), parE I476F (1), gyrA S114G (2 with mosaic gyrA genes), and gyrA N150H (1 with a mosaic gyrA gene).
†An isolate was considered to have an efflux phenotype for the indicated fluoroquinolone when a >2-fold decrease in its MIC in the presence of reserpine was observed.
‡Indicates that the residue is located in a recombinant gene.
§R6CS80P, R6 derivative carrying parC S80P; T1AS81V, T1-derivative carrying gyrA S81V; T1AE85G, T1-derivative carrying gyrA E85K.

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