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Sanz JC, Rodríguez-Avial I, Ríos E, García-Comas L, Ordobás M, Cercenado E. Increase of serotype 8, ST53 clone, as the prevalent strain of Streptococcus pneumoniae causing invasive disease in Madrid, Spain (2012-2015). Enferm Infecc Microbiol Clin 2019; 38:105-110. [PMID: 31253424 DOI: 10.1016/j.eimc.2019.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/14/2019] [Accepted: 05/16/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION In recent years, Streptococcus pneumoniae serotype 8 has become the most prevalent cause of invasive pneumococcal disease (IPD) in Madrid, Spain. The objective of this study was to characterize the invasive clones of S. pneumoniae serotype 8 in Madrid over the 2012-2015 period. METHODS From January 2012 to December 2015, a total of 1543 invasive isolates were studied. Serotyping was carried out by Pneumotest-Latex agglutination and Quellung reaction. Susceptibilities to penicillin, erythromycin and levofloxacin were determined by the Etest®. All serotype 8 strains were typed by multilocus sequence typing (MLST) and by pulsed-field gel electrophoresis (PFGE). RESULTS Two hundred and forty-eight (248) serotype 8 strains were detected (16.1%) and 243 of them were available for molecular typing. Nine sequence types (STs) by MLST (8-ST53, 8-ST63, 8-ST404, 8-ST1107, 8-ST989, 8-ST1110, 8-ST2231, 8-ST3544 and 8-ST4301), and nine PFGE profiles were identified (one corresponding to each ST). The 8-ST53 clone was the most widespread, and increased from 53.8% among all serotype 8 isolates in 2012, to 90.1% in 2015. In contrast, the 8-ST63 clone, resistant to levofloxacin and erythromycin, decreased from 30.8%, among all serotype 8 strains in 2012, to 5.0% in 2015. CONCLUSIONS The increase in our region of S. pneumoniae serotype 8, not included in conjugated vaccines, occurred at the expense of the 8-ST53 clone. On the contrary, the 8-ST63 clone decreased. Since clone 8-ST63 has the theoretical advantage of its levofloxacin-erythromycin resistance in comparison to 8-ST53, the predominance of 8-ST53 over 8-ST63 is striking.
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Affiliation(s)
- Juan Carlos Sanz
- Unidad de Microbiología Clínica, Laboratorio Regional de Salud Pública, Dirección General de Salud Pública, Comunidad de Madrid, Centro de Especialidades Médicas Vicente Soldevilla 2ª planta, Madrid 28053, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | | | - Esther Ríos
- Servicio de Microbiología, Hospital Clínico San Carlos, Madrid 28040, Spain
| | - Luis García-Comas
- Servicio de Epidemiología, Dirección General de Salud Pública, Comunidad de Madrid, 28035, Spain
| | - María Ordobás
- Servicio de Epidemiología, Dirección General de Salud Pública, Comunidad de Madrid, 28035, Spain
| | - Emilia Cercenado
- Servicio de Microbiología, Hospital General Universitario Gregorio Marañón, Madrid 28007, Spain
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Silva LA, Coronato B, Schlackman J, Marsh JW, Ezeonwuka C, Fernandes ACL, Souza VC, da Silva LS, de Amorim EFQ, Naveca FG, de Albuquerque BC, Amaral A, Souza ALS, Carvalho-Costa FA, Mustapha MM, Harrison LH, Barroso DE. Neisseria meningitidis disease-associated clones in Amazonas State, Brazil. Infect Dis (Lond) 2018; 50:697-704. [PMID: 29623748 DOI: 10.1080/23744235.2018.1459829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The aim of this study is to describe the molecular epidemiology of Neisseria meningitidis invasive disease before the introduction of serogroup C conjugate vaccine in Amazonas State in 2010. METHODS Meningococcal disease reported cases were investigated in Amazonas State during the period 2000-2010. N. meningitidis isolates (n = 196) recovered from patients were genotyped by multilocus sequence typing (MLST) and sequencing of porB, porA, fetA, fHbp and penA. Antimicrobial susceptibility was determined using E-test. RESULTS In the study period, 948 cases were reported; the incidence was 2.8 for the entire state and 4.8 per 100,000 in the capital of Manaus. Most meningococcal disease was caused by N. meningitidis belonging to ST-32 (72%; 141/196) or ST-103 (21%; 41/196) clonal complexes. Capsular switching (B→C) was suggested within clonal complex (cc) 32. There were 6 (3%; 6/196) strains with intermediate susceptibility to penicillin and a single strain was resistant to rifampicin. Since 2007, serogroup C strains belonging to the cc103 have predominated and case-fatality has increased. CONCLUSION We demonstrate a high rate of meningococcal disease in Amazonas State, where, like other parts of Brazil, serogroup C replaced serogroup B during 2000s. These data serve as a baseline to measure impact of serogroup C conjugate vaccine introduction in 2010. This study emphasizes the need for enhanced surveillance to monitor changes in meningococcal disease trends following the introduction of meningococcal vaccines.
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Affiliation(s)
- Luciete A Silva
- a Laboratory of Microbial Diversity of Importance to Health and Laboratory of Communicable Disease Ecology , Leônidas & Maria Deane Institute, FIOCRUZ , Manaus , Brazil
| | - Beatriz Coronato
- b Laboratory of Epidemiology and Molecular Systematics , Oswaldo Cruz Institute, FIOCRUZ , Rio de Janeiro , Brazil
| | - Jessica Schlackman
- c Infectious Diseases Epidemiology Research Unit , University of Pittsburgh School of Medicine and Graduate School of Public Health , Pittsburgh , PA , USA
| | - Jane W Marsh
- c Infectious Diseases Epidemiology Research Unit , University of Pittsburgh School of Medicine and Graduate School of Public Health , Pittsburgh , PA , USA
| | - Chinelo Ezeonwuka
- c Infectious Diseases Epidemiology Research Unit , University of Pittsburgh School of Medicine and Graduate School of Public Health , Pittsburgh , PA , USA
| | - Andréia C L Fernandes
- b Laboratory of Epidemiology and Molecular Systematics , Oswaldo Cruz Institute, FIOCRUZ , Rio de Janeiro , Brazil
| | - Victor C Souza
- a Laboratory of Microbial Diversity of Importance to Health and Laboratory of Communicable Disease Ecology , Leônidas & Maria Deane Institute, FIOCRUZ , Manaus , Brazil
| | - Lirna S da Silva
- a Laboratory of Microbial Diversity of Importance to Health and Laboratory of Communicable Disease Ecology , Leônidas & Maria Deane Institute, FIOCRUZ , Manaus , Brazil
| | - Elaine F Q de Amorim
- a Laboratory of Microbial Diversity of Importance to Health and Laboratory of Communicable Disease Ecology , Leônidas & Maria Deane Institute, FIOCRUZ , Manaus , Brazil
| | - Felipe G Naveca
- a Laboratory of Microbial Diversity of Importance to Health and Laboratory of Communicable Disease Ecology , Leônidas & Maria Deane Institute, FIOCRUZ , Manaus , Brazil
| | - Bernardino C de Albuquerque
- d Department of Epidemiological Surveillance and Central Laboratory , Foundation of Health Surveillance of Amazonas , Manaus , AM , Brazil
| | - Alcirene Amaral
- d Department of Epidemiological Surveillance and Central Laboratory , Foundation of Health Surveillance of Amazonas , Manaus , AM , Brazil
| | - Ana L S Souza
- d Department of Epidemiological Surveillance and Central Laboratory , Foundation of Health Surveillance of Amazonas , Manaus , AM , Brazil
| | - Filipe A Carvalho-Costa
- b Laboratory of Epidemiology and Molecular Systematics , Oswaldo Cruz Institute, FIOCRUZ , Rio de Janeiro , Brazil.,e Regional Technical Office, FIOCRUZ , Teresina , Brazil
| | - Mustapha M Mustapha
- c Infectious Diseases Epidemiology Research Unit , University of Pittsburgh School of Medicine and Graduate School of Public Health , Pittsburgh , PA , USA
| | - Lee H Harrison
- c Infectious Diseases Epidemiology Research Unit , University of Pittsburgh School of Medicine and Graduate School of Public Health , Pittsburgh , PA , USA
| | - David E Barroso
- b Laboratory of Epidemiology and Molecular Systematics , Oswaldo Cruz Institute, FIOCRUZ , Rio de Janeiro , Brazil
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Giufrè M, Accogli M, Ricchizzi E, Barbanti F, Farina C, Fazii P, Mattei R, Sarti M, Barozzi A, Buttazzi R, Cosentino M, Nardone M, Savini V, Spigaglia P, Moro ML, Cerquetti M. Multidrug-resistant infections in long-term care facilities: extended-spectrum β-lactamase-producing Enterobacteriaceae and hypervirulent antibiotic resistant Clostridium difficile. Diagn Microbiol Infect Dis 2018; 91:275-281. [PMID: 29571838 DOI: 10.1016/j.diagmicrobio.2018.02.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/15/2017] [Accepted: 02/23/2018] [Indexed: 11/30/2022]
Abstract
Infections due to multidrug-resistant (MDR) organisms in long-term care facilities (LTCFs) residents constitute a public health concern. This multicenter study investigated the frequency of ESBL-producing pathogens and MDR Clostridium difficile in clinical specimens from LTCF residents in Italy. During October 2014-March 2015, all urine and diarrheic fecal samples from LTCF residents (≥65 years) with suspected urinary tract infection or C. difficile infection, respectively, received for diagnosis by 4 hospital laboratories located in different cities were analyzed. Antibiotic susceptibility testing, characterization of resistance genes, and molecular typing of pathogens were performed. Of 806 urine cultures collected from 626 residents at 44 different LTCFs, 492 were positive for microbial infection. Of these, 158 were positive for at least an ESBL-producing Enterobacteriaceae species (32.1%), with Escherichia coli as the most frequent ESBL pathogen (23.4%) followed by Klebsiella pneumoniae (4.5%). Furthermore, 4 carbapenemase producers (0.8%) (1 E. coli with VIM-1and 3 K. pneumoniae with KPC-3) were detected. The CTX-M-15 type ESBL predominated in both E. coli (71.3%) and K. pneumoniae (77.3%). Most E. coli isolates (82.6%) belonged to the ST131/H30 clone/subclone. For K. pneumoniae, ST307 and ST15 were frequent (31.8% and 22.7%, respectively), but isolates harboring blaKPC-3 belonged to CC258. Of 136 diarrheic fecal samples collected from 111 residents at 26 different LTCFs, 21 (15.4%) were positive for toxigenic C. difficile; of these, 13 (62%) were MDR (resistant to 3 or more antimicrobial agents of different classes). The predominant C. difficile polymerase chain reaction ribotype was 356/607 (42.9%), followed by 018, 449, and 078 (14% each). Public health efforts are needed to contain the diffusion of CTX-M-producing Enterobacteriaceae and MDR C. difficile in LTCF settings.
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Affiliation(s)
- Maria Giufrè
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Marisa Accogli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Fabrizio Barbanti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | | | | | - Mario Sarti
- S. Agostino-Estense-Baggiovara Hospital, Modena, Italy
| | | | | | | | | | | | - Patrizia Spigaglia
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Marina Cerquetti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
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