New Composite Genetic Element of the Tn 916 Family with Dual Macrolide Resistance Genes in a Streptococcus pneumoniae Isolate Belonging to Clonal Complex 271

Antimicrobial Agents and Chemotherapy
2009.0

Abstract

Clonal complex 271 (CC271) is one of the emerging multidrug-resistant clones of Streptococcus pneumoniae, spreading in many areas of the globe and including serotype 19F and the nonvaccine serotype 19A. CC271 pneumococci often carry dual macrolide resistance genes erm(B) and mef(E). We examined a serotype 19F S. pneumoniae isolate (S43) belonging to CC271 (sequence type 1428), obtained in Hungary in 2003 from an infant with meningitis. S43 was multidrug resistant, showing resistance to penicillin, erythromycin, clindamycin, and tetracycline and carrying erm(B), mef(E), and tet(M). PCR mapping and sequence analysis were performed to verify the presence of transposons. A 182-bp deletion in Tn917 (positions 240-421) was found. Sequence analysis of a 1,053-bp fragment showed the left end of Tn917 was inserted in orf9 of Tn916 in proximity to the insertion of mega in orf6 of Tn916, forming a composite transposon of ca. 28.5 kb designated Tn2017 (a new modular combination of Tn916, Tn917, and mega). The left and right junctions of Tn2017 in S43 were identical to those described for Tn2010 in CC271 isolates. In a previous study, three dual-gene isolates from Italy belonging to CC15 contained Tn916, Tn917, and mega but carried Tn3872 with Tn917 inserted in Tn916, while mega was independently inserted in spr0166. These findings indicate that in order to correctly trace the spreading of the antibiotic resistance determinants, it is necessary to define the physical linkage between the resistance elements identified and the boundaries of the exogenous elements in the chromosome.

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