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Antimicrob. Agents Chemother. doi:10.1128/AAC.00358-08
Copyright (c) 2008, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Temporal and Spatial Distribution of Clonal Complexes of Streptococcus pneumoniae Resistant to Multiple Classes of Antibiotics in Belgium, 1997-2004

GlaxoSmithKline, 5 Moore Drive, Research Triangle Park, North Carolina 27709; University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium; GlaxoSmithKline, 1250 S. Collegeville Road, Collegeville, PA 19426; Pharma Institute of Philadelphia, 3612 Earlham St., Philadelphia, Pennsylvania 19129

^* To whom correspondence should be addressed. Email: heather.a.madsen{at}gsk.com.

	Abstract

We performed multilocus sequence typing on 203 invasive disease isolates of Streptococcus pneumoniae to assess the clonal composition of isolates from two provinces in Belgium and to determine the relationship between clones and antibiotic non-susceptibility, particularly non-susceptibility to two or more classes of antibiotics. The frequency of multi-class non-susceptibility (MCNS) was higher in the province of West Flanders (38%) than in Limburg (21%). This difference was largely attributable to five clonal complexes (CC156, CC81, CC143, CC193, and CC1848), which contained high proportions of MCNS (>47%), and which were circulating at higher frequencies in West Flanders. The S. pneumoniae population changed over time, as CC156 and CC81 declined in frequency from 1997-1999 to 2001-2004. Over the same time period, the frequency of pneumococcal conjugate vaccine-7 (PCV7) serotypes dropped from 69% to 41%. In contrast, the non-vaccine serotype 19A increased in frequency from 2.1% to 6.6%. None of these changes can be attributed to PCV7 vaccine, as it was not in use in Belgium during the time period studied. There was evidence that MCNS clones flowed from West Flanders to Limburg.