Purpose. The aim of this study was to characterize serogroup 19 isolates resistant to macrolides and/or penicillin found among pneumococci recovered from cases of invasive and respiratory tract disease in the Czech Republic in 2014.Methods. Pneumococcal isolates of serotypes 19A (n=26) and 19F (n=10) that were non-susceptible to penicillin and/or macrolides and had been collected in 2014 were analysed using multi-locus sequence typing (MLST). Four isolates representing the major clones were subjected to whole-genome sequencing (WGS).Results. The penicillin-susceptible macrolide-resistant isolates of serotype 19A were mainly associated with sequence type (ST) 416 belonging to clonal complex (CC) 199, and the penicillin-resistant isolates were of serotype 19F belonging to ST1464 (CC 320). WGS revealed the presence of pilus 1, in association with pilus 2, in serotype19F isolates belonging to CC 320. Another adhesin, pneumococcal serine-rich protein (PsrP), was only present in serotype 19A isolates of ST416. Analysis of the penicillin-binding proteins (PBPs) of serotype 19F penicillin-resistant isolates (ST1464 and ST271) performed on PBP1a, 2b and 2x identified a large number of mutations in comparison to the reference strain, R6. Both isolates contained a unique PBP profile; however, they were highly similar to PBP sequences of the Taiwan19F-14 reference strain. The Pbp2b sequences of both 19F isolates showed the lowest similarity to those of the Taiwan19F-14 strain (91 % similarity), while they were also found to be distantly related to each other (94 % similarity).Conclusions. WGS revealed specific virulence factors in antibiotic-resistant pneumococcal clones that spread rapidly in the post-vaccine era in the Czech Republic.

• Keywords
• MLST, Streptoccoccus pneumoniae, WGS,
• MeSH
• Anti-Bacterial Agents pharmacology   MeSH
• Genes, Bacterial MeSH
• Drug Resistance, Bacterial MeSH
• Child MeSH
• Adult MeSH
• Phenotype MeSH
• Genotype MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Molecular Typing * MeSH
• Pneumococcal Infections epidemiology   microbiology   prevention & control   MeSH
• Pneumococcal Vaccines administration & dosage   immunology   MeSH
• Child, Preschool MeSH
• Whole Genome Sequencing MeSH
• Aged MeSH
• Serogroup * MeSH
• Streptococcus pneumoniae classification   drug effects   genetics   isolation & purification   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Child, Preschool MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH
• Names of Substances
• Anti-Bacterial Agents MeSH
• Pneumococcal Vaccines MeSH

Two cases are presented of severe pneumococcal infections in infants caused by serotype 14 Streptococcus pneumoniae. The first case--meningitis--caused by S. pneumoniae (pneumococcus) with low-level penicillin susceptibility has developed from acute otitis media and resulted in fatal outcome. The second one--an immunocompromised child presenting recurrent otitis and chronic mastoiditis--developed into pneumococcal pneumonia. Both cases demonstrate the extreme importance of a relevant initial treatment of localized pneumococcal infections, preventing the development of generalized infection. Amoxicillin (an oral treatment option in both upper and lower respiratory tract infections caused also by Pneumococcus strains with low-level penicillin susceptibility due to its beneficial pharmacokinetics and pharmacodynamics) was not used in either case.

• MeSH
• Anti-Bacterial Agents therapeutic use   MeSH
• Child MeSH
• Fatal Outcome MeSH
• Immunocompromised Host MeSH
• Infant MeSH
• Humans MeSH
• Meningitis, Bacterial diagnosis   microbiology   pathology   MeSH
• Otitis Media complications   MeSH
• Pneumococcal Infections diagnosis   microbiology   pathology   MeSH
• Pneumonia, Pneumococcal diagnosis   microbiology   pathology   MeSH
• Penicillin Resistance MeSH
• Serotyping MeSH
• Streptococcus pneumoniae classification   isolation & purification   MeSH
• Bacterial Typing Techniques MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• Anti-Bacterial Agents MeSH

The in vitro activity of the new naphthyridone trovafloxacin (CP 99,219) was compared with those of penicillin G and six other agents (cefpodoxime, erythromycin, azithromycin, clindamycin, ciprofloxacin, and sparfloxacin) against 316 penicillin-susceptible and -resistant pneumococci isolated in the former Czechoslovakia. Trovafloxacin was very active against strains of Streptococcus pneumoniae (MIC50 and MIC90 0.25 microgram/ml). Ciprofloxacin was less active (MIC50 1.0 microgram/ml, MIC90 2.0 micrograms/ml), and MICs of sparfloxacin were between those of trovafloxacin and ciprofloxacin (MIC50 and MIC90 both 0.5 microgram/ml). MICs of cefpodoxime, erythromycin, azithromycin, and clindamycin were higher for strains intermediately resistant or resistant to penicillin than for penicillin-susceptible strains.

• MeSH
• Anti-Infective Agents pharmacology   MeSH
• Fluoroquinolones * MeSH
• Humans MeSH
• Microbial Sensitivity Tests MeSH
• Naphthyridines pharmacology   MeSH
• Penicillin G pharmacology   MeSH
• Penicillins pharmacology   MeSH
• Streptococcus pneumoniae drug effects   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• Anti-Infective Agents MeSH
• Fluoroquinolones * MeSH
• Naphthyridines MeSH
• Penicillin G MeSH
• Penicillins MeSH
• trovafloxacin MeSH Browser