TY - JOUR AU - Chen, Yi-Yin AU - Hsieh, Yu-Chia AU - Gong, Yu-Nong AU - Liao, Wei-Chao AU - Li, Shiao-Wen AU - Chang, Ian Yi-Feng AU - Lin, Tzu-Lung AU - Huang, Ching-Tai AU - Chiu, Cheng-Hsiu AU - Wu, Tsu-Lan AU - Su, Lin-Hui AU - Li, Ting-Hsuan AU - Huang, Ya-Yu T1 - Genomic Insight into the Spread of Meropenem-Resistant Streptococcus pneumoniae Spain-ST81, Taiwan T2 - Emerging Infectious Disease journal PY - 2020 VL - 26 IS - 4 SP - 711 SN - 1080-6059 AB - Incidence of invasive pneumococcal disease caused by antimicrobial-resistant Streptococcus pneumoniae types not included in pneumococcal conjugate vaccines has increased, including a penicillin- and meropenem-resistant serotype 15A-ST63 clone in Japan. During 2013–2017, we collected 206 invasive pneumococcal isolates in Taiwan for penicillin and meropenem susceptibility testing. We found serotypes 15B/C-ST83 and 15A-ST63 were the most prevalent penicillin- and meropenem-resistant clones. A transformation study confirmed that penicillin-binding protein (PBP) 2b was the primary meropenem resistance determinant, and PBP1a was essential for high-level resistance. The rate of serotype 15B/C-ST83 increased during the study. All 15B/C-ST83 isolates showed an ermB macrolide resistance genotype. Prediction analysis of recombination sites revealed 12 recombination regions in 15B/C-ST83 compared with the S. pneumoniae Spain23F-ST81 genome. Pneumococcal clones rapidly recombine to acquire survival advantages and undergo local expansion under the selective pressure exerted by vaccines and antimicrobial drugs. The spread of 15B/C-ST83 is alarming for countries with high antimicrobial pressure. KW - 15B/C KW - invasive pneumococcal disease KW - PCV-13 KW - meropenem resistance KW - genome sequencing KW - antimicrobial resistance KW - bacteria KW - AMR KW - Taiwan KW - Streptococcus pneumoniae KW - meningitis KW - pneumonia KW - sepsis DO - 10.3201/eid2604.190717 UR - https://wwwnc.cdc.gov/eid/article/26/4/19-0717_article ER - End of Reference