{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T18:55:25Z","timestamp":1763751325548,"version":"3.45.0"},"reference-count":22,"publisher":"BMJ","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1997,10]]},"abstract":"<jats:p>AIMS: To characterise the genotypes of penicillin resistant Streptococcus pneumoniae infecting patients in a care of the elderly ward and to study its transmission in a hospital environment. METHODS: Isolates of S pneumoniae were cultured from specimens obtained from patients who had been admitted to a care of the elderly ward where an outbreak had occurred. Penicillin resistant S pneumoniae were also obtained from a series of surveillance throat swabs taken from patients in the same ward. In addition, all penicillin resistant S pneumoniae isolated from specimens submitted for culture at the time of the outbreak were included. Four sensitive strains isolated from a routine microbiology laboratory were included as controls. A simple polymerase chain reaction (PCR) based genotyping method for the penicillin binding protein (PBP) genes 1a, 2x, and 2b was used to characterise the genotypes. RESULTS: Nine patients were infected with serotype 9 S pneumoniae. Four of these patients died; two deaths were directly attributable to the infection. Tested against a battery of haemolytic streptococci and other organisms found in the respiratory tract, only two false positive reactions for PBP 2x were found among S mitis. The method demonstrated that the outbreak strain had altered PBP 1a, 2b, and 2x genes, a pattern clearly distinguishable from other penicillin resistant strains isolated at the same time. CONCLUSIONS: This method is simple to perform and would enable many laboratories to characterise the genotype of penicillin resistant S pneumoniae and investigate transmission in their hospitals.<\/jats:p>","DOI":"10.1136\/jcp.50.10.847","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"847-851","source":"Crossref","is-referenced-by-count":14,"title":["An outbreak of penicillin resistant Streptococcus pneumoniae investigated by a polymerase chain reaction based genotyping method."],"prefix":"10.1136","volume":"50","author":[{"given":"S H","family":"Gillespie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T D","family":"McHugh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J E","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Dickens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M S","family":"Kyi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Kelsey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1997,10,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1099\/00222615-28-4-237","article-title":"Aspects of pneumococcal infection including bacterial virulence, host response and vaccination","volume":"28","author":"Gillespie, S.H.","year":"1988","unstructured":"Gillespie SH. 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N EnglJ Med 1971;284:175-7.","journal-title":"N EnglJ Med"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1093\/jac\/4.6.481","article-title":"Multiple-antibiotic resistancenow the pneumococcus","volume":"4","author":"Jacobs, M.R.; Koornhof, H.F.","year":"1978","unstructured":"Jacobs MR, Koornhof HF. Multiple-antibiotic resistancenow the pneumococcus. J Antimicrob Chemother 1978;4: 481-3.","journal-title":"J Antimicrob Chemother"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/0966-842X(94)90612-2","article-title":"Origin and molecular epidemiology of penicillin binding protein mediated resistance to P-lactam antibiotics","volume":"2","author":"Dowson, C.G.; Coffey, T.J.; Spratt, B.G.","year":"1994","unstructured":"Dowson CG, Coffey TJ, Spratt BG. Origin and molecular epidemiology of penicillin binding protein mediated resistance to P-lactam antibiotics. Trends Microbiol 1994;2:361-5.","journal-title":"Trends Microbiol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1093\/infdis\/163.3.542","article-title":"Extremely high incidence of antibiotic resistance in clinical isolates of Streptococcus pneumoniae in Hungary","volume":"163","author":"Marton, A.; Gulyas, M.; Munoz, R.; Tomasz, A.","year":"1991","unstructured":"Marton A, Gulyas M, Munoz R, Tomasz A. Extremely high incidence of antibiotic resistance in clinical isolates of Streptococcus pneumoniae in Hungary. J Infect Dis 1991;163:542-8.","journal-title":"J Infect Dis"},{"issue":"10","key":"ref_7","first-page":"335","article-title":"Horizontal spread of an altered penicillin-binding protein 2b gene between Streptococcus pneumoniae and Streptococcus oralis","volume":"1","author":"Coffey, T.J.; Dowson, C.G.; Daniels, M.; Spratt, B.G.","year":"1993","unstructured":"Coffey TJ, Dowson CG, Daniels M, Spratt BG. 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Mol Microbiol 1991;5: 1993-2002.","journal-title":"Mol Microbiol"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1099\/00222615-35-6-367","article-title":"A scheme for the identification of viridans streptococci","volume":"35","author":"Beighton, D.; Hardie, J.M.; Whiley, R.A.","year":"1991","unstructured":"Beighton D, Hardie JM, Whiley RA. A scheme for the identification of viridans streptococci. J Med Microbiol 1991;35: 367-72.","journal-title":"J Med Microbiol"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1093\/infdis\/164.2.302","article-title":"Intercontinental spread of a multiresistant clone of serotype 23F Streptococcus pneumoniae","volume":"164","author":"Munoz, R.; Coffey, T.J.; Daniels, M.; Dowson, C.G.; Laible, G.; Casal, J.","year":"1991","unstructured":"Munoz R, Coffey TJ, Daniels M, Dowson CG, Laible G, Casal J, et al. Intercontinental spread of a multiresistant clone of serotype 23F Streptococcus pneumoniae. J Infect Dis 1991;164:302-6.","journal-title":"J Infect Dis"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2724","DOI":"10.1128\/JCM.31.10.2724-2728.1993","article-title":"DNA fingerprinting of Streptococcus pneumoniae strains by pulsedfield gel electrophoresis","volume":"31","author":"Lefevre, J.C.; Faucon, G.; Sicard, A.M.; Gasc, A.M.","year":"1993","unstructured":"Lefevre JC, Faucon G, Sicard AM, Gasc AM. DNA fingerprinting of Streptococcus pneumoniae strains by pulsedfield gel electrophoresis. J Clin Microbiol 1993;31:2724-8.","journal-title":"J Clin Microbiol"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1093\/infdis\/173.1.128","article-title":"Sub-typing of common pediatric pneumococcal serotypes from invasive disease and pharyngeal carriage in Finland","volume":"173","author":"Takala, A.K.; Vuopio-Varkila, J.; Tarkka, E.; Leinonen, M.; Musser, J.M.","year":"1996","unstructured":"Takala AK, Vuopio-Varkila J, Tarkka E, Leinonen M, Musser JM. Sub-typing of common pediatric pneumococcal serotypes from invasive disease and pharyngeal carriage in Finland.J Infect Dis 1996;173:128-35.","journal-title":"J Infect Dis"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1099\/00207713-41-4-543","article-title":"Streptococcus cristae sp. nov., a viridans Streptococcus with tufted fibrils, isolated from the human oral cavity and throat","volume":"41","author":"Handley, P.; Coykendall, A.; Beighton, D.; Hardie, J.M.; Whiley, R.A.","year":"1991","unstructured":"Handley P, Coykendall A, Beighton D, Hardie JM, Whiley RA. Streptococcus cristae sp. nov., a viridans Streptococcus with tufted fibrils, isolated from the human oral cavity and throat. IntJ Syst Bacteriol 1991;41:543-7.","journal-title":"IntJ Syst Bacteriol"},{"key":"ref_14","first-page":"2623","article-title":"DNA-DNA hybridisation studies and phenotypic characteristics of strains within the Streptococcus milleri group","volume":"135","author":"Whiley, R.A.; Hardie, J.M.","year":"1989","unstructured":"Whiley RA, Hardie JM. DNA-DNA hybridisation studies and phenotypic characteristics of strains within the Streptococcus milleri group. J Gen Microbiol 1989;135: 2623-33.","journal-title":"J Gen Microbiol"},{"key":"ref_15","article-title":"Methods for dilution antimicrobial susceptibility tests for organisms that grow aerobically","author":"National Committee for Clinical Laboratory Standards,","year":"1993","unstructured":"National Committee for Clinical Laboratory Standards. Methods for dilution antimicrobial susceptibility tests for organisms that grow aerobically, 3rd edn; approved standard. Villanova: National Committee for Clinical Laboratory Standards, 1993.","edition":"3rd edn"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1001\/jama.1996.03530270046030","article-title":"Minimizing the impact of drug resistant Streptococcus pneumoniae (DRSP). A strategy from the DRSP working group","volume":"275","author":"Jerningan, D.B.; Cetron, M.S.; Breiman, R.F.","year":"1996","unstructured":"Jerningan DB, Cetron MS, Breiman RF. Minimizing the impact of drug resistant Streptococcus pneumoniae (DRSP). A strategy from the DRSP working group. JAMA 1996;275:206-9.","journal-title":"JAMA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1128\/JCM.11.5.488-491.1980","article-title":"Coagglutination and counterimmunoelectrophoresis for detection of pneumococcal antigens in the sputum of pneumonia patients","volume":"11","author":"Edwards, E.A.; Coonrod, J.D.","year":"1980","unstructured":"Edwards EA, Coonrod JD. Coagglutination and counterimmunoelectrophoresis for detection of pneumococcal antigens in the sputum of pneumonia patients. J Clin Microbiol 1980;11:488-91.","journal-title":"J Clin Microbiol"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1136\/jcp.47.8.749","article-title":"Diagnosis of Streptococcus pneumoniae pneumonia by quantitative enzyme linked immunosorbent assay of C-polysaccharide antigen","volume":"47","author":"Gillespie, S.H.; Smith, M.D.; Dickens, A.; Raynes, J.G.; McAdam, K.P.","year":"1994","unstructured":"Gillespie SH, Smith MD, Dickens A, Raynes JG, McAdam KP. Diagnosis of Streptococcus pneumoniae pneumonia by quantitative enzyme linked immunosorbent assay of C-polysaccharide antigen. Jf Clin Pathol 1994;47:749-5 1.","journal-title":"Jf Clin Pathol"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1128\/JCM.32.5.1308-1311.1994","article-title":"Detection of Streptococcus pneumoniae in sputum samples by PCR","volume":"32","author":"Gillespie, S.H.; Ullman, C.; Smith, M.D.; Emery, V.","year":"1994","unstructured":"Gillespie SH, Ullman C, Smith, MD, Emery V. Detection of Streptococcus pneumoniae in sputum samples by PCR. J Clin Microbiol 1994;32:1308-11.","journal-title":"J Clin Microbiol"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"4382","DOI":"10.1128\/IAI.61.10.4382-4391.1993","article-title":"Molecular epidemiology of penicillin-resistant pneumococci isolated in Nairobi, Kenya","volume":"61","author":"Kell, C.M.; Jordens, Z.; Daniels, M.; Coffey, T.J.; Bates, J.; Paul, J.","year":"1993","unstructured":"Kell CM, Jordens Z, Daniels M, Coffey TJ, Bates J, Paul J, et al. Molecular epidemiology of penicillin-resistant pneumococci isolated in Nairobi, Kenya. Infect Immun 1993;61: 4382-91.","journal-title":"Infect Immun"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1128\/JCM.33.3.596-601.1995","article-title":"Detection of Streptococcus pneumoniae in whole blood by PCR","volume":"33","author":"Zhang, Y.; Isaacman, D.J.; Wadowsky, R.M.; Rydquist-White, J.; Post, J.C.; Erlich, G.D.","year":"1995","unstructured":"Zhang Y, Isaacman DJ, Wadowsky RM, Rydquist-White J, Post JC, Erlich GD. Detection of Streptococcus pneumoniae in whole blood by PCR. J Clin Microbiol 1995;33:596-601.","journal-title":"J Clin Microbiol"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1128\/JCM.34.3.592-596.1996","article-title":"Combinational detection of autolysin and penicillin binding protein 2B genes of Streptococcus pneumoniae by PCR","volume":"34","author":"Ubulata, K.; Asahi, Y.; Yamane, A.; Konno, M.","year":"1996","unstructured":"Ubulata K, Asahi Y, Yamane A, Konno M. Combinational detection of autolysin and penicillin binding protein 2B genes of Streptococcus pneumoniae by PCR. 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