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Clonally Related Penicillin-Nonsusceptible Streptococcus pneumoniae Serotype 14 from Cases of Meningitis in Salvador, Brazil

2000; Oxford University Press; Volume: 30; Issue: 1 Linguagem: Inglês

10.1086/313619

1537-6591

Albert I. Ko, Joyce Neves Reis, Steven J. Coppola, Edilane Lins Gouveia, Soraia Machado Cordeiro, Tatiana S. Lôbo, Ricardo M. Pinheiro, Kátia Salgado, Cibele Maria Ribeiro Dourado, José Tavares‐Neto, Heonir Rocha, Mitermayer Galvão dos Reis, William D. Johnson, Lee W. Riley,

Pneumocystis jirovecii pneumonia detection and treatment

Active hospital-based surveillance in the city of Salvador, Brazil, from December 1995 through October 1998, identified 221 patients with confirmed pneumococcal meningitis. Of these 221 patients, 29 (13%) had isolates with intermediate-level resistance to penicillin. Infection with these penicillin-nonsusceptible isolates was significantly associated with age of <2 years (P < .0019), previous antibiotic use (P < .0006), and coresistance to trimethoprim-sulfamethoxazole (P < .0000). Serotype 14 was the most prevalent serotype (55.2%) of penicillin-nonsusceptible isolates. Strain typing by repetitive element BOX polymerase chain reaction (PCR) analysis showed that penicillin-nonsusceptible serotype 14 isolates had closely related BOX PCR patterns, whereas penicillin-susceptible serotype 14 isolates each had distinct, unrelated patterns. Penicillin-nonsusceptible serotype 14 isolates from Salvador and other Brazilian cities had similar BOX PCR patterns. These observations indicate that in Brazil a large proportion of cases of penicillin-nonsusceptible pneumococcal meningitis appear to be caused by a closely related group of serotype 14 strains that may have disseminated to widely separate geographic areas.