CHARACTERIZATION OF STREPTOCOCCUS-PNEUMONIAE FROM HUMAN IMMUNODEFICIENCY VIRUS-SEROPOSITIVE PATIENTS WITH ACUTE AND RECURRENT PNEUMONIA

Thirty-two isolates of clinically significant Streptococcus pneumoniae from 11 human immunodeficiency virus (HIV)-seropositive patients with single or multiple episodes of pneumonia were characterized by antibi otic susceptibility testing, serotyping, ribotyping, and repetitive ex tragenic palindromic polymerase chain reaction (REP-PCR). The isolates comprised 10 serotypes, 12 ribotyping patterns, and 12 REP-PCR patter ns, There was close but not absolute correlation between techniques. B y combining these characterization methods, 14 strains were identified . Five strains were found in >1 patient, suggesting their frequent occ urrence in this population. Two isolates of different serotype from 1 patient were highly related by ribotyping and REP-PCR, suggesting poss ible in vivo serotype change, Acute infection was associated with sing le strains or coinfection by distinct strains, Recurrent pneumonia was identified as relapse with the same strain or reinfection with new st rains. The molecular characterization of pneumococci from HIV-seroposi tive persons refines our understanding of pneumococcal infection in th ese patients.