PMID- 28961888
OWN - NLM
STAT- MEDLINE
DCOM- 20180702
LR  - 20180702
IS  - 1460-2091 (Electronic)
IS  - 0305-7453 (Linking)
VI  - 72
IP  - 12
DP  - 2017 Dec 1
TI  - Multiclonal emergence of levofloxacin-resistant group B Streptococcus, Taiwan.
PG  - 3263-3271
LID - 10.1093/jac/dkx297 [doi]
AB  - Objectives: 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. Methods: 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. Results: 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 and <65-year-old adult outpatients, while serotype
      II and VI isolates were mostly from respiratory and urine samples and
      >65-year-old inpatients. Multivariate analysis revealed that elderly age and
      respiratory samples were independent factors associated with levofloxacin
      resistance. Conclusions: 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.
CI  - (c) The Author 2017. Published by Oxford University Press on behalf of the
      British Society for Antimicrobial Chemotherapy. All rights reserved. For
      Permissions, please email: journals.permissions@oup.com.
FAU - Wu, Chi-Jung
AU  - Wu CJ
AD  - National Institute of Infectious Diseases and Vaccinology, National Health
      Research Institutes, Zhunan, Taiwan.
AD  - Department of Internal Medicine, National Cheng Kung University Hospital, College
      of Medicine, National Cheng Kung University, Tainan, Taiwan.
FAU - Lai, Jui-Fen
AU  - Lai JF
AD  - National Institute of Infectious Diseases and Vaccinology, National Health
      Research Institutes, Zhunan, Taiwan.
FAU - Huang, I-Wen
AU  - Huang IW
AD  - National Institute of Infectious Diseases and Vaccinology, National Health
      Research Institutes, Zhunan, Taiwan.
FAU - Hsieh, Li-Yun
AU  - Hsieh LY
AD  - National Institute of Infectious Diseases and Vaccinology, National Health
      Research Institutes, Zhunan, Taiwan.
FAU - Wang, Hui-Ying
AU  - Wang HY
AD  - National Institute of Infectious Diseases and Vaccinology, National Health
      Research Institutes, Zhunan, Taiwan.
FAU - Shiau, Yih-Ru
AU  - Shiau YR
AD  - National Institute of Infectious Diseases and Vaccinology, National Health
      Research Institutes, Zhunan, Taiwan.
FAU - Lauderdale, Tsai-Ling
AU  - Lauderdale TL
AD  - National Institute of Infectious Diseases and Vaccinology, National Health
      Research Institutes, Zhunan, Taiwan.
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Antimicrob Chemother
JT  - The Journal of antimicrobial chemotherapy
JID - 7513617
RN  - 0 (Anti-Bacterial Agents)
RN  - 6GNT3Y5LMF (Levofloxacin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Bacterial Agents/*pharmacology
MH  - Child
MH  - Child, Preschool
MH  - Cross Infection/microbiology
MH  - DNA Mutational Analysis
MH  - *Drug Resistance, Bacterial
MH  - Electrophoresis, Gel, Pulsed-Field
MH  - Female
MH  - *Genotype
MH  - Hospitals
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Levofloxacin/*pharmacology
MH  - Male
MH  - Middle Aged
MH  - Multilocus Sequence Typing
MH  - Serotyping
MH  - Streptococcal Infections/*microbiology
MH  - Streptococcus agalactiae/classification/*drug effects/*genetics/isolation &
      purification
MH  - Taiwan
MH  - Young Adult
EDAT- 2017/09/30 06:00
MHDA- 2018/07/03 06:00
CRDT- 2017/09/30 06:00
PHST- 2017/05/19 00:00 [received]
PHST- 2017/07/24 00:00 [accepted]
PHST- 2017/09/30 06:00 [pubmed]
PHST- 2018/07/03 06:00 [medline]
PHST- 2017/09/30 06:00 [entrez]
AID - 4106328 [pii]
AID - 10.1093/jac/dkx297 [doi]
PST - ppublish
SO  - J Antimicrob Chemother. 2017 Dec 1;72(12):3263-3271. doi: 10.1093/jac/dkx297.