PENICILLIN-RESISTANT STREPTOCOCCUS-PNEUMONIAE IN THE NETHERLANDS - RESULTS OF A 1-YEAR MOLECULAR EPIDEMIOLOGIC SURVEY

The molecular epidemiologic characteristics of penicillin-resistant pn eumococci in the Netherlands were investigated in 1995. Dutch electron ic surveillance data showed that 0.7% of all pneumococci were intermed iately resistant and 0.4% were highly resistant to penicillin. From Ma rch 1995 to March 1996, 89 penicillin-resistant isolates were collecte d by 39 medical microbiology laboratories. Thirty different genotypes were observed by restriction fragment end labeling. Twenty-one DNA typ es were unique, whereas 9 distinct genotypes were shared by greater th an or equal to 2 isolates, Different serogroups were found within 6 of the 9 genetically identical clusters of penicillin-resistant isolates , suggesting that horizontal transfer of capsular genes is common. Fin ally, nosocomial transmission of penicillin-resistant pneumococci was observed among 21 elderly adults with chronic obstructive pulmonary di sease. This study demonstrates that multiple clones of penicillin-resi stant pneumococci have been introduced in the Netherlands, a country w ith a low prevalence of pneumococcal infection. Some clones spread amo ng the population in and outside hospitals.