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Volume 20, Number 5—May 2014

Research

Persistence and Complex Evolution of Fluoroquinolone-Resistant Streptococcus pneumoniae Clone

Debby Ben-DavidComments to Author , Mitchell J. Schwaber, Amos Adler, Samira Masarwa, Rotem Edgar, Shiri Navon-Venezia, David Schwartz, Nurith Porat, Tali Kotlovsky, Nikolay Polivkin, Irina Weinberg, Avraham Lazary, Nissim Ohana, and Ron Dagan
Author affiliations: National Center for Infection Control, Tel Aviv, Israel (D. Ben-David, M.J. Schwaber, A. Adler, S. Masarwa, R. Edgar, S. Navon-Venezia); Sourasky Medical Center, Tel Aviv (D. Schwartz, N. Porat, T. Kotlovsky, R. Dagan); Ben-Gurion University of the Negev, Beer-Sheva (N. Porat, R. Dagan); Reuth Medical Center, Tel Aviv (N. Polivkin, I. Weinberg, A. Lazary, N. Ohana)

Main Article

Table 1

Characterization of Streptococcus pneumoniae and quinolone resistance–determining region sequences of type II topoisomerase enzymes GyrA, GyrB, and ParC in a post–acute care facility, Israel, 2006–2011*

Isolate
Serotype
PFGE
type
MLST
GyrA GyrB ParC ParE Etest†
Missense mutation
Silent
mutation
Missense mutation
Silent
mutation
Missense mutation
Silent
mutation
Missense mutation
Silent
mutation
mxf
ofx
cip
Lev
109 19F D ST156 Spain 9V-3 S81F V381, G384, L386 S79Y Q41 6, R >32, R >32, R >32, R
116 19F E ST156 Spain 9V-3 S81F V381, G384, L386 S79Y Q41 6, R >32, R >32, R >32, R
129 23F A2 ST156 Spain 9V-3 S81F V381, G384, L386 S79Y Q41 6, R >32, R >32, R >32, R
182 23F A ST156 Spain 9V-3 S81F V381, G384, L386 S79Y Q41 6, R >32, R >32, R >32, R
190 19F C ST81 Spain 23F-1 N461, A472 K137N Q41, G128 I460V I476 0.19, S 4, I 1.5, S 1, S
177 19F C ND V381, G384, L386 K137N Q41, G128 A326V, E474K I460V I476 0.19, S 4, I 6, I 1.5, I
200 15B‡ H ND Q41 I460V 0.125, S 2, S 1, S 0.75, S

*PFGE, pulsed-field gel electrophoresis; MLST, multilocus sequence typing; ND, not determined; I, intermediate; R, resistance; –, no mutations detected. Boldface font indicates mutations from the literature that conferred fluoroquinolone resistance; underline indicates mutation not recorded in literature; italics font indicates mutation not contributing to fluoroquinolone resistance; regular font indicates silent mutations, all are transition: V381 (gtA-gtG), G384 (ggA-ggG), L386 (ttG-ttA), N461 (aaC aaT), A472 (gcT-gcC), Q41 (caA-caG), G128 (ggC-ggT), I476 (atC-atT)
†Performed on brain-hHeart + blood agar plates and plates were incubated at 35°C CO2.
‡15B is a susceptible reference strain.

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