抗生素耐药与新型抗生素BacterialPathogens in the Hospital and Community The Need for Newer .pptVIP

The largest percentage decline (82%) and the largest absolute rate reduction in overall IPD (175.8 cases per 100,000) were observed among children aged 1 year, the age group with the highest baseline rate (Table). The incidence of PCV7-type IPD decreased significantly among all children aged 5 years from 1998--1999 to 2005. The largest absolute rate reduction in PCV7-type disease was observed among children aged 1 year (175.7 cases per 100,000). Non-PCV7--type IPD increased significantly among children aged 1 year and 4 years (Table). Objectives: Multidrug-resistant Streptococcus pneumoniae isolates of serotype 19A have emerged all over the world in recent years. The aim of this study was to characterize highly penicillin-resistant pneumococcal strains of the 19A serotype, collected in Spain from 1997 to 2007 from patients with invasive disease. Methods: Antibiotic susceptibility was studied by microdilution. All penicillin-resistant pneumococci were typed by PFGE and selected strains were studied by multilocus sequence typing (MLST). The presence of genes related to the Tn916 family of transposons was investigated by PCR. Results: From a total of 1197 invasive pneumococcal isolates of serotype 19A received at the Spanish Reference Laboratory between 1997 and 2007, 51 (4.3%) strains showed high-level resistance to penicillin (MICs of 2–4 mg/L). These 51 isolates belonged to three multiresistant clones related to sequence type (ST)81 (n521), ST320 (n519) and ST276 (n511). All 51 serotype 19A pneumococci were tetracycline-resistant and had the tet(M) gene, and 41 strains were macrolide-resistant, harbouring the erm(B) gene. The presence of int and xis genes was detected in all strains associated with other genes of the Tn916 family. Conclusions: The rise in penicillin-resistant serotype 19A invasive pneumococci in Spain was associated with the emergence and clonal spread of two worldwide-disseminated multiresistant clones (ST276 and ST320). The Spain23F-1-19A (ST81)