@article{3115486,
    title = "Characterisation of macrolide-non-susceptible Streptococcus pneumoniae
colonising children attending day-care centres in Athens, Greece during
2000 and 2003",
    author = "Souli, M. and Volonakis, K. and Kapaskelis, A. and Galani, I. and and Grammelis, V. and Vorou, R. and Tsivra, M. and Chryssouli, Z. and and Katsala, D. and Giamarellou, H.",
    journal = "Clinical Microbiology and Infection",
    year = "2007",
    volume = "13",
    number = "1",
    pages = "70-77",
    publisher = "Elsevier Sci Ltd, Exeter, United Kingdom",
    issn = "1198-743X",
    doi = "10.1111/j.1469-0691.2006.01555.x",
    keywords = "children; colonisation; day-care centres; macrolide resistance;
pneumococci; surveillance",
    abstract = "Nasopharyngeal Streptococcus pneumoniae isolates colonising young
children are representative of isolates causing clinical disease. This
study determined the frequency of macrolide-non-susceptible pneumococci,
as well as their phenotypic and genotypic characteristics, among
pneumococci collected during two cross-sectional surveillance studies of
the nasopharynx of 2847 children attending day-care centres in the
Athens metropolitan area during 2000 and 2003. In total, 227
macrolide-non-susceptible pneumococcal isolates were studied. Increases
in macrolide non-susceptibility, from 23% to 30.3% (p < 0.05), and in
macrolide and penicillin co-resistance, from 3.4% to 48.6% (p <
0.001), were identified during the study period. The M resistance
phenotype, associated with the presence of the mef(A)/(E) gene,
predominated in both surveys, and isolates carrying both mef(A)/(E) and
erm(AM) were identified, for the first time in Greece, among the
isolates from the 2003 survey. Pulsed-field gel electrophoresis analysis
of the isolates from the 2000 survey indicated the spread of a
macrolide- and penicillin-resistant clone among day-care centres. The
serogroups identified most commonly in the study were 19F, 6A, 6B, 14
and 23F, suggesting that the theoretical protection of the seven-valent
conjugate vaccine against macrolide-non-susceptible isolates was c. 85%
during both study periods."
}