Persistence and Complex Evolution of Fluoroquinolone-Resistant Streptococcus pneumoniae Clone

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.

Keywords

• Streptococcus pneumoniae
• fluoroquinolones
• antimicrobial drug resistance
• long-term acute care hospital
• clonal evolution
• bacteria