@article{3082309,
    title = "Genetic relatedness of resistant and multiresistant Streptococcus
pneumoniae strains, recovered in the Athens area, to international
clones",
    author = "Tsolia, MN and Stamos, G and Ioannidou, S and Trefler, R and Foustoukou, and M and Kafetzis, D and Porat, N",
    journal = "Microbial Drug Resistance: Mechanism, Epidemiology, and Disease",
    year = "2002",
    volume = "8",
    number = "3",
    pages = "219-226",
    publisher = "MARY ANN LIEBERT INC PUBL",
    issn = "1076-6294, 1931-8448",
    doi = "10.1089/107662902760326940",
    abstract = "The prevalence of resistance to antibiotics was examined among 318
Streptococcus pneumoniae strains isolated during 1998 and 1999 in a
children’s hospital in Athens. The rate of resistance to penicillin was
25.8% (intermediate 22%, resistant 3.8%); 42.5% of the strains were
resistant to greater than or equal to1 antibiotic and 20% were
multidrug resistant. Resistance to penicillin was lowest in invasive
strains (8.3%) and highest in ear isolates (31%). A review of the same
microbiology laboratory’s records revealed that there has been a gradual
increase in penicillin resistance since 1988-1989, when it was 5%.
Capsular types were determined for 77 strains resistant to 2:1
antibiotic, and 69 (90%) of them belonged to the following five
serotypes: 19F, 14, 9V, 23F, and 6B. Seventy-five strains were analyzed
by pulsed-field gel electrophoresis (PFGE) and 59/75 (79%) shared five
electrophoretic types. The largest cluster consisted of 19 serotype 19F
strains, of which 18 were nonsusceptible to penicillin and most were
multidrug resistant and shared a common and distinct electrophoretic
pattern not resembling any known clone. A group of 17 strains that were
nonsusceptible to penicillin belonged to serotypes 9V (10), 14 (6), and
19F (1) and shared a common PFGE type similar to the international clone
Spain(9V)-3. Seven serotype 23F strains, of which five were multidrug
resistant, belonged to the international clone Spain(23F)-1. Among the
strains susceptible to penicillin but resistant to non-beta-lactam
antibiotics, the largest cluster consisted of 13 isolates resistant to
erythromycin that belonged to serotype 14 and shared an electrophoretic
pattern characteristic of the clone England(14)-9. Finally, three
serotype 6B strains were penicillin susceptible and multidrug resistant
and had features similar to the Mediterranean 6B clone. The introduction
and spread of several antibiotic-resistant international clones accounts
at least in part for the increase in pneumococcal resistance observed in
recent years in the Athens metropolitan area."
}