ABSTRACT
Prolonged outbreaks of multidrug-resistant Streptococcus pneumoniae in health care facilities are uncommon. We found persistent transmission of a fluroquinolone-resistant S. pneumoniae clone during 2006-2011 in a post-acute care facility in Israel, despite mandatory vaccination and fluoroquinolone restriction. Capsular switch and multiple antimicrobial nonsusceptibility mutations occurred within this single clone. The persistent transmission of fluoroquinolone-resistant S. pneumoniae during a 5-year period underscores the importance of long-term care facilities as potential reservoirs of multidrug-resistant streptococci.
Subject(s)
Anti-Bacterial Agents/pharmacology , Biological Evolution , Drug Resistance, Bacterial/genetics , Fluoroquinolones/pharmacology , Pneumococcal Infections/epidemiology , Streptococcus pneumoniae/drug effects , Streptococcus pneumoniae/genetics , Adult , Aged , Aged, 80 and over , Child , Cross Infection , Disease Outbreaks , Hospitals , Humans , Israel/epidemiology , Microbial Sensitivity Tests , Middle Aged , Pneumococcal Infections/microbiology , Prevalence , Public Health Surveillance , Serotyping , Streptococcus pneumoniae/classification , Young AdultABSTRACT
We aimed to study the prevalence of Streptococcus pneumoniae in respiratory samples from institutionalized patients with chronic tracheostomy. A total of 264 pairs of nasopharyngeal and endotracheal cultures were collected. There was no difference in the proportion of positive cultures between children (21%) and adults (18%). However, the proportion of positive endotracheal cultures was higher than that of nasopharyngeal cultures in adults (18% versus 3%, respectively; P < 0.001) but not in children (17% in both sites).
