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Genetic diversity of fluoroquinolone-nonsusceptible Streptococcus pneumoniae clinical isolates and the first identification of serotype 20B in China

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Abstract

The purpose of this study was to investigate the genetic characteristics of fluoroquinolone-nonsusceptible Streptococcus pneumoniae clinical isolates in China. A total of 377 S. pneumoniae clinical isolates, including 307 pediatric strains and 70 adult strains, were collected from eight centers in China. The minimal inhibitory concentrations (MICs) of 10 antimicrobial agents were determined by agar dilution. Multilocus sequence typing (MLST), serotyping, and quinolone resistance-determining region (QRDR) variations were conducted in levofloxacin-nonsusceptible isolates by polymerase chain reaction (PCR)-based methods. Seven levofloxacin-nonsusceptible isolates were found, with an overall resistance rate of 1.9 % (7/377) and 8.6 % (6/70) in adults. Sequence analyses of parC, gyrA, and parE QRDRs in levofloxacin-resistant isolates demonstrated mutations in dual target sites at the hot spots. These seven strains represented multiple clones: two strains were serotype 19F (Taiwan19F-14) and MLST clonal complex (CC) 271/320, two were typed as 23F (Spain23F-1) and CC81, two were determined as serotype 20B and a new sequence type of ST6935, and one non-serotypeable pediatric strain belonged to a new sequence type of ST6946. Two serotype 19F strains possessed a variety of characteristic alterations of viridans group streptococci in gyrA (Ser114Gly) or parC (Ser52Gly, Asn91Asp). Fluoroquinolone-nonsusceptible S. pneumoniae isolates showed a substantial degree of genetic diversity and belonged to pre-existing epidemic clones together with native clones. S. pneumoniae strains with serotype 20B was recovered for the first time to be associated with levofloxacin resistance in China.

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Acknowledgments

We thank David C. Hooper (Massachusetts General Hospital, Boston, MA, USA) very much for his critical review of the manuscript. We are grateful to the pneumococcal MLST database, which is located at Imperial College London and funded by the Wellcome Trust, and we thank its curator, Cynthia Bishop, for the designation of the new alleles and allelic profiles.

This work was supported by grant nos. 81102509 and 81120108024 from the National Natural Science Foundation of China and grant no. 10ZR1405600 from the Shanghai Municipal Science and Technology Commission.

Conflict of interest

None of the authors has any conflicts of interest to disclose.

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Authors and Affiliations

  1. Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, 200040, China

    Q. Guo, S. Zhang, J. Huang, F. Hu, D. Zhu, F. Yang & M. Wang

  2. Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, 200040, China

    Q. Guo, S. Zhang, J. Huang, F. Hu, D. Zhu, F. Yang & M. Wang

  3. State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou, 510120, China

    C. Zhuo

  4. Peking Union Medical College Hospital, China Academy of Sciences, Beijing, 100730, China

    Y. Xu

  5. The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China

    W. Huang

  6. Children’s Hospital of Fudan University, Shanghai, 201102, China

    C. Wang

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  1. Q. Guo
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  2. C. Zhuo
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  3. Y. Xu
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  4. W. Huang
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  5. C. Wang
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  6. S. Zhang
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  7. J. Huang
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  8. F. Hu
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  9. D. Zhu
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  10. F. Yang
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  11. M. Wang
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Corresponding author

Correspondence to F. Yang.

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Guo, Q., Zhuo, C., Xu, Y. et al. Genetic diversity of fluoroquinolone-nonsusceptible Streptococcus pneumoniae clinical isolates and the first identification of serotype 20B in China. Eur J Clin Microbiol Infect Dis 33, 465–470 (2014). https://doi.org/10.1007/s10096-013-1979-5

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  • DOI: https://doi.org/10.1007/s10096-013-1979-5

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