Multiclonal emergence of levofloxacin-resistant group B Streptococcus, Taiwan

Autor: I-Wen Huang, Hui-Ying Wang, Yih-Ru Shiau, Tsai-Ling Lauderdale, Li-Yun Hsieh, Chi-Jung Wu, Jui-Fen Lai
Rok vydání: 2017
Předmět:
0301 basic medicine
Microbiology (medical)
Serotype
Adult
Male
Adolescent
Genotype
030106 microbiology
DNA Mutational Analysis
Taiwan
Erythromycin
Drug resistance
Levofloxacin
Biology
Meropenem
Microbiology
Streptococcus agalactiae
03 medical and health sciences
Young Adult
0302 clinical medicine
Antibiotic resistance
Streptococcal Infections
Drug Resistance
Bacterial
medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
Serotyping
Child
Aged
Pharmacology
Aged
80 and over
Cross Infection
Broth microdilution
Infant
Newborn
Infant
biochemical phenomena
metabolism
and nutrition
Middle Aged
bacterial infections and mycoses
Hospitals
Anti-Bacterial Agents
Electrophoresis
Gel
Pulsed-Field
Penicillin
Infectious Diseases
Child
Preschool
Female
medicine.drug
Multilocus Sequence Typing
Zdroj: The Journal of antimicrobial chemotherapy. 72(12)
ISSN: 1460-2091
Popis: This study investigated the trend in antimicrobial resistance among group B Streptococcus (GBS) from a national surveillance programme in Taiwan and delineated characteristics of and factors associated with levofloxacin-resistant isolates.Clinical isolates of all sample types and patient groups were collected from multiple hospitals biennially between 2002 and 2012. Susceptibilities to different antibiotics were determined by broth microdilution. Molecular studies of levofloxacin-resistant isolates included serotyping, PFGE, mutations in the QRDRs and MLST.A total of 1559 isolates were tested and all remained susceptible to penicillin, cephalosporins, meropenem and vancomycin. However, levofloxacin resistance increased from 2.2% (range 0%-3.3%) in 2002-06 to 6.2% (5.9%-7.5%) in 2008-12 (P = 0.016). Among the 88 levofloxacin-resistant isolates, the majority (79.5%) had the GyrA(S81L)+ParC(S79F/Y) double mutations and most (54.5%) were also resistant to clindamycin, erythromycin and tetracycline. The predominant genotype of the levofloxacin-resistant isolates was ST19/serotype III (43.2%). Four previously unreported genotypes, ST1 and its single-locus variants (ST920 and ST922)/serotype VI (28.4%) and ST1/serotype II (18.2%), were found to have circulated locally. Serotype III isolates were predominately from urine and female genital tract specimens and65-year-old adult outpatients, while serotype II and VI isolates were mostly from respiratory and urine samples and65-year-old inpatients. Multivariate analysis revealed that elderly age and respiratory samples were independent factors associated with levofloxacin resistance.Multiclonal emergence and dissemination of levofloxacin-resistant GBS isolates occurred in healthcare and community settings in Taiwan. Continuous molecular-level surveillance is important to detect new epidemic trends.
Databáze: OpenAIRE
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