Search

To estimate the invasive disease potential of Streptococcus pneumoniae serotypes, invasive isolates (n=138) were compared with nasopharyngeal isolates (n=153) from children under 6 years of age in the Czech Republic. Odds ratios (ORs) based on a comparison of the distribution of S. pneumoniae serotypes amongst invasive and carriage isolates were calculated for individual serotypes and 172 strains were characterized using multilocus sequence typing. The ORs of serotypes 9V and 14 were significantly greater than 1, suggesting an association with invasive disease, while serotypes 6A and 23F were significantly associated with carriage (ORs less than 1). A single predominant clone with high invasive disease potential was found in each of the 9V, 7F, 14 and 1 serotypes while carriage-associated serotypes were highly heterogeneous.

We conducted surveillance on invasive pneumococci isolated from adults in the Czech Republic during 1996-2003. The 7 most prevalent serotypes were characterized. Coverage with the 7-valent pneumococcal conjugate vaccine was low. Our observations confirm that detection methods may have modified the expected effect of this vaccine.

Over the last decade, epidemic and frequently multidrug-resistant Pseudomonas aeruginosa has increasingly been found among European cystic fibrosis (CF) patients. In the Czech Republic, more than half of the registered CF patients attend the Prague CF centre. At this centre, a Burkholderia cenocepacia strain was recently found to have spread among the patients. The aim of the present study was to assess whether P. aeruginosa isolates from patients at this centre were also genetically related and, if so, whether they were multidrug-resistant. We investigated a collection of 69 isolates from as many patients who represented 80% of the total number of P. aeruginosa-positive patients in 2004. The organisms were typed by AFLP and SpeI macrorestriction analyses (PFGE). Using these methods, 44 unique strains and nine groups of two to five isolates each were distinguished. Among these groups, two each had a prevalence of 7% in the patient population, while others had a prevalence of < or =3%. The diversity observed with PFGE was largely in agreement with the diversity found by AFLP analysis. All isolates were susceptible to colistin; 94-96% were susceptible to piperacillin, ceftazidime, cefepime, meropenem, amikacin or tobramycin; and 84-87% were susceptible to ciprofloxacin, gentamicin or netilmicin. In conclusion, the organisms recovered from Czech CF patients showed high genotypic diversity and good susceptibility to antipseudomonal agents. The absence of highly epidemic P. aeruginosa strains may result from infection control measures taken upon recognition of the epidemic B. cenocepacia.

Among 1,011 recently isolated Streptococcus pyogenes isolates from 10 Central and Eastern European centers, the MICs at which 50% of isolates are inhibited (MIC(50)s) and the MIC(90)s were as follows: for telithromycin, 0.03 and 0.06 microg/ml, respectively; for erythromycin, azithromycin, and clarithromycin, 0.06 to 0.125 and 1 to 8 microg/ml, respectively; and for clindamycin, 0.125 and 0.125 microg/ml, respectively. Erythromycin resistance occurred in 12.3% of strains. Erm(A) [subclass erm(TR)] was most commonly encountered (60.5%), followed by mef(A) (23.4%) and erm(B) (14.5%). At <0.5 microg/ml, telithromycin was active against 98.5% of the strains tested.

Seventy-two penicillin-resistant Streptococcus pneumoniae isolates collected from clinical specimens in the Czech and Slovakian Republics between 1990 and 1992 were analyzed by a variety of molecular techniques. Most of the highly resistant isolates (40/72) (penicillin MIC between 1 up to 16 micrograms/ml) were represented by two distinct pneumococcal clones, and most of these isolates (35/40) were also resistant to at least two other antibiotics (tetracycline plus chloramphenicol or erythromycin). All 17 isolates belonging to the first clone were of serotype 14, had very high penicillin MICs (8-12 micrograms/ml), shared a common, abnormal penicillin-binding protein (PBP) pattern and one of two related pulsed-field gel electrophoretic (PFGE) patterns. The 15 isolates belonging to the second clone were all of serotype 19A, had penicillin MICs between 1 and 4 micrograms/ml, shared a unique, abnormal PBP pattern, and could be divided into two subgroups on the basis of PFGE patterns, one of which was indistinguishable from the PFGE pattern of a multiresistant capsular type 19A clone of S. pneumoniae already identified earlier in Hungary. Thirty-two of the 72 pneumococcal isolates had lower penicillin MICs (0.1-0.5 microgram/ml), and these isolates differed from the more highly resistant ones in several respects: They belonged to seven different serotypes, showed large variation in PFGE patterns (20 patterns in 32 isolates) and most of them (21/32) were resistant to penicillin only. Tentative explanations for these findings, in terms of epidemiological and molecular mechanisms, are considered.