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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 3

Fluoroquinolone MICs of 68 high-level resistant Streptococcus pneumoniae isolates 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
4 F F 64 16–32 4 CIP
21 F F 32–128 16–32 2–8 None
1 F L 64 32 2 None
1 F V 64 32 4 CIP
3 F Y 64–128 16–32 4 None
1 F G 32 16 4 None
2 F K 32–64 16–32 2–4 None
1 Y‡ –‡ –‡ –‡ –‡ F‡ –‡ 64 32 4 None
8 Y F 32–64 16–32 2–4 None
1 Y F 64 32 4 CIP, LVX
1 Y Y 64 32 4 None
1 Y K 32 16 2 None
1 P F 16 4 0.5 None
1 H F 32 16 2 CIP
1 Y F 32 16 2 CIP
2 Y F 32 8–16 2–4 None
1 N K 16 8 2 None
3 N F 16 8 0.5–2 None
1 –‡ –‡ –‡ N‡ –‡ F‡ –‡ 16 4 0.5 CIP
1 F G F 64 32 4 CIP, LVX
2 F G F 32–64 32 4 None
1 F G L 64 64 16 None
1 F H F 64 32 4 None
2 F N F 32–64 16–32 4 None
2 F N F 64–128 32–128 4–32 None
1 F N K 16 32 4 None
1 F K F 64 32 4 None
1 F F A 64 16 4 None
1 F F K 32 32 4 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 D83E (1), parC K137 N (24), parC N91D (2 with mosaic parC genes), parE I460V (47), and gyrA S114G (2 with mosaic gyrA genes).
†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.

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