Genetic Diversity and Clonal Patterns among Antibiotic-Susceptible and -Resistant Streptococcus pneumoniae Colonizing Children: Day Care Centers as Autonomous Epidemiological Units

Author:

Sá-Leão Raquel12,Tomasz Alexander2,Sanches Ilda Santos13,Nunes Sónia1,Alves C. Rute1,Avô António Brito4,Saldanha Joana5,Kristinsson Karl G.6,de Lencastre Hermínia12

Affiliation:

1. Instituto de Tecnologia Quı́mica e Biológica da Universidade Nova de Lisboa, Oeiras,1

2. The Rockefeller University, New York, New York2; and

3. Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa, Monte da Caparica,3 and

4. Gabinete de Medicina Pedagógica4 and

5. Hospital de Sta. Maria,5 Lisbon, Portugal;

6. National University Hospital, Reykjavı́k, Iceland6

Abstract

ABSTRACT Characterization by antibiotype of the 1,096 Streptococcus pneumoniae recovered from 2,111 nasopharyngeal samples of children attending 16 day care centers (DCCs) in Lisbon, Portugal, and molecular typing of 413 drug-resistant pneumococci (DRPn) and 89 fully drug-susceptible pneumococci (DSPn) has allowed several conclusions. (i) There was an increase in the frequency of DRPn colonizing children in DCCs from 40% in 1996 to 45% in 1997 to 50% in 1998. (ii) Drug resistance spread by cross-transmission of DRPn clones. A few (8 out of 57) DRPn clones were repeatedly isolated from a large number of children in several DCCs and during each period of surveillance, suggesting the epidemic nature of these clones, which included lineages representing internationally spread S. pneumoniae clones. (iii) Dissemination of resistance determinants among pneumococci colonizing the nasopharynx occurred. Association of identical pulsed-field gel electrophoresis patterns with diverse antibiotypes among pneumococci colonizing children suggests that the high prevalence of DRPn involves not only cross-transmission of resistant strains but also dispersal of resistance genes through recombinational mechanisms. (iv) DCCs are autonomous epidemiological units. Among the 413 DRPn, 57 different lineages were detected; these lineages were dispersed among the 16 DCCs to produce unique microbiological profiles for each of the DCCs. Higher genetic diversity and less sharing of clonal types were observed among the DSPn.

Publisher

American Society for Microbiology

Subject

Microbiology (medical)

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