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Volume 23, Number 6—June 2017

Research

Invasive Serotype 35B Pneumococci Including an Expanding Serotype Switch Lineage, United States, 2015–2016

Sopio Chochua, Benjamin J. Metcalf, Zhongya Li, Hollis Walker, Theresa Tran, Lesley McGee, and Bernard BeallComments to Author 
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

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Table 2

Nonserotype 35B isolates of ST156 lineage included in study of penicillin-nonsusceptible 35B pneumococcal isolates causing IPD, United States, 1998–2015*

Serotype/ MLST type (no.)† No. PBP type‡ Non-PBP resistance determinants§ Antimicrobial resistance phenotype, MIC, μg/mL¶
State (year isolated)
Pen Amo Tax Cft Cfx Mer Ery Cli + Tet Cot Fq
9V/156 (25)
12 15:12:18 folAI100L, folPins178 4 2 1 2 >2 0.5 S S R S CA, GA, MD, MN, NY, TN (1998–1999)
9 15:12:18 mef, folAI100, folPins178 4 2 1 2 >2 0.5 R S R S CA, CT, MD, MN, OR, TN (1998,1999, 2015)
2 15:12:18 ermB, tetM, folAI100L, folAins178 4 2 1 2 >2 0.5 R R R S CA (2015)
1 15:12:18 mef, tetM, folAI100L, folPins178 4 2 1 2 >2 0.5 R S R S CT (2015)
1
15:12:228
Mef, folAI100L, folPins178
4
2
1
2
>2
0.5
R
S
R
S
MD (2016)
19A/156 (4)
3 29:12:26 mef, folAI100L, folAins189 4 2 8 4 >2 0.5 R S R S CA,GA (2009)
1
8:12:36
mef, folAI100L, folAins189
1
2
0.5
0.5
2
0.25
R
S
R
S
GA (2015)
13/156 (1)
1
15:12:173
folAI100L, folPins178
1
1
0.25
0.25
1
0.5
S
S
R
S
TN (2015)
31/156 (1) 1 15:12:18 mef, folAI100L, folPins178 4 2 1 2 >2 0.5 R S R S MN (2015)

*All isolates were positive for pilus PI-type 1 and negative for pilus PI-type 2. IPD, invasive pneumococcal disease; MLST, multilocus sequence type; PBP, penicillin-binding protein; R, resistant; S, susceptible; ST, sequence type.
†Types that probably arose through serotype switching are indicated in bold.
‡See Li et al. (15) and MIC correlates for PBP types (http://www.cdc.gov/streplab/mic-tables.html).
§For a description of WGS-based bioinformatic pipeline for deduction of all features shown, see Metcalf et al. (6,12). For a description of folP insertions (folPins178, folP189), see Figure 1 in Metcalf et al. (12).
¶Predicted MICs for β-lactam antimicrobial drugs were based on transpeptidase domain sequences of PBPs 1a, 2b, and 2x (http://www.cdc.gov/streplab/mic-tables.html). For penicillin (meningitis only), nonsusceptible is considered >0.12 μg/mL (16). Currently applied clinical cutoffs are also provided for the other 5 β-lactams shown (16). Where shown, R and S correspond to breakpoint MIC values (16). Amo, amoxicillin; Cft, ceftriaxone; Cfx, cefuroxime; Cli, clindamycin; Cot, cotrimoxazole; Ery, erythromycin; Fq, fluoroquinolones levofloxacin and ciprofloxacin; Mer, meropenem; Pen, penicillin; Tax, cefotaxime.

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