Skip to main content
Molecular Pathology : MP logoLink to Molecular Pathology : MP
. 1997 Feb;50(1):45–50. doi: 10.1136/mp.50.1.45

Determination of penicillin susceptibility of Streptococcus pneumoniae using the polymerase chain reaction.

H Jalal 1, S Organji 1, J Reynolds 1, D Bennett 1, E O'Mason Jr 1, M R Millar 1
PMCID: PMC379578  PMID: 9208813

Abstract

AIM: To develop a polymerase chain reaction (PCR) based method to detect penicillin susceptibility in isolates of Streptococcus pneumoniae (SP). METHOD: PCR primers were designed to amplify differential nucleotide sequences of the penicillin-binding protein (PBP) genes 2b, 2x, and 1a in penicillin susceptible and resistant strains of SP. Primers derived from the PBP 2x and 2b genes were designed to amplify products from penicillin susceptible S pneumoniae (PSSP), whereas primers derived from the PBP 1a gene were designed to amplify gene sequences of penicillin resistant S pneumoniae (PRSP). RESULTS: Two hundred and thirty clinical isolates of SP from the USA, UK, Kenya, Romania, and the Kingdom of Saudi Arabia were tested. Of the isolates, 116 were penicillin susceptible, 65 were intermediately resistant, and 49 were highly resistant. PCR identified 108 (93%) of 116 of PSSP isolates, 55 (85%) of 65 intermediately resistant isolates, and all of the 49 highly resistant isolates of SP. The susceptibility of 16 (7%) isolates could not be determined using PCR. All of these 16 isolates had a minimum inhibitory concentration (MIC) of penicillin < 1 mg/l. None of the highly resistant isolates was identified as penicillin susceptible by PCR, although two of the isolates with intermediate resistance (MIC = 0.125 mg/l) were. CONCLUSION: Using primers that differentially identify the genotypes of susceptible and resistant strains of SP, PCR provides a rapid method for determining the penicillin susceptibility of SP isolates and could potentially be used for testing clinical samples.

Full text

PDF

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ajello G. W., Bolan G. A., Hayes P. S., Lehmann D., Montgomery J., Feeley J. C., Perlino C. A., Broome C. V. Commercial latex agglutination tests for detection of Haemophilus influenzae type b and Streptococcus pneumoniae antigens in patients with bacteremic pneumonia. J Clin Microbiol. 1987 Aug;25(8):1388–1391. doi: 10.1128/jcm.25.8.1388-1391.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Baquero F. Pneumococcal resistance to beta-lactam antibiotics: a global geographic overview. Microb Drug Resist. 1995 Summer;1(2):115–120. doi: 10.1089/mdr.1995.1.115. [DOI] [PubMed] [Google Scholar]
  3. Barcus V. A., Ghanekar K., Yeo M., Coffey T. J., Dowson C. G. Genetics of high level penicillin resistance in clinical isolates of Streptococcus pneumoniae. FEMS Microbiol Lett. 1995 Mar 1;126(3):299–303. doi: 10.1111/j.1574-6968.1995.tb07433.x. [DOI] [PubMed] [Google Scholar]
  4. Caputo G. M., Appelbaum P. C., Liu H. H. Infections due to penicillin-resistant pneumococci. Clinical, epidemiologic, and microbiologic features. Arch Intern Med. 1993 Jun 14;153(11):1301–1310. [PubMed] [Google Scholar]
  5. Dowson C. G., Coffey T. J., Kell C., Whiley R. A. Evolution of penicillin resistance in Streptococcus pneumoniae; the role of Streptococcus mitis in the formation of a low affinity PBP2B in S. pneumoniae. Mol Microbiol. 1993 Aug;9(3):635–643. doi: 10.1111/j.1365-2958.1993.tb01723.x. [DOI] [PubMed] [Google Scholar]
  6. Dowson C. G., Hutchison A., Spratt B. G. Extensive re-modelling of the transpeptidase domain of penicillin-binding protein 2B of a penicillin-resistant South African isolate of Streptococcus pneumoniae. Mol Microbiol. 1989 Jan;3(1):95–102. doi: 10.1111/j.1365-2958.1989.tb00108.x. [DOI] [PubMed] [Google Scholar]
  7. Dutka-Malen S., Evers S., Courvalin P. Detection of glycopeptide resistance genotypes and identification to the species level of clinically relevant enterococci by PCR. J Clin Microbiol. 1995 Jan;33(1):24–27. doi: 10.1128/jcm.33.1.24-27.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Friedland L. R., Menon A. G., Reising S. F., Ruddy R. M., Hassett D. J. Development of a polymerase chain reaction assay to detect the presence of Streptococcus pneumoniae DNA. Diagn Microbiol Infect Dis. 1994 Dec;20(4):187–193. doi: 10.1016/0732-8893(94)90002-7. [DOI] [PubMed] [Google Scholar]
  9. Gillespie S. H., Ullman C., Smith M. D., Emery V. Detection of Streptococcus pneumoniae in sputum samples by PCR. J Clin Microbiol. 1994 May;32(5):1308–1311. doi: 10.1128/jcm.32.5.1308-1311.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hakenbeck R., Tarpay M., Tomasz A. Multiple changes of penicillin-binding proteins in penicillin-resistant clinical isolates of Streptococcus pneumoniae. Antimicrob Agents Chemother. 1980 Mar;17(3):364–371. doi: 10.1128/aac.17.3.364. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hassan-King M., Baldeh I., Secka O., Falade A., Greenwood B. Detection of Streptococcus pneumoniae DNA in blood cultures by PCR. J Clin Microbiol. 1994 Jul;32(7):1721–1724. doi: 10.1128/jcm.32.7.1721-1724.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Heym B., Alzari P. M., Honoré N., Cole S. T. Missense mutations in the catalase-peroxidase gene, katG, are associated with isoniazid resistance in Mycobacterium tuberculosis. Mol Microbiol. 1995 Jan;15(2):235–245. doi: 10.1111/j.1365-2958.1995.tb02238.x. [DOI] [PubMed] [Google Scholar]
  13. Hofmann J., Cetron M. S., Farley M. M., Baughman W. S., Facklam R. R., Elliott J. A., Deaver K. A., Breiman R. F. The prevalence of drug-resistant Streptococcus pneumoniae in Atlanta. N Engl J Med. 1995 Aug 24;333(8):481–486. doi: 10.1056/NEJM199508243330803. [DOI] [PubMed] [Google Scholar]
  14. Klugman K. P., Saunders J. Pneumococci resistant to extended-spectrum cephalosporins in South Africa. Lancet. 1993 May 1;341(8853):1164–1164. doi: 10.1016/0140-6736(93)93195-7. [DOI] [PubMed] [Google Scholar]
  15. Korten V., Huang W. M., Murray B. E. Analysis by PCR and direct DNA sequencing of gyrA mutations associated with fluoroquinolone resistance in Enterococcus faecalis. Antimicrob Agents Chemother. 1994 Sep;38(9):2091–2094. doi: 10.1128/aac.38.9.2091. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Laible G., Spratt B. G., Hakenbeck R. Interspecies recombinational events during the evolution of altered PBP 2x genes in penicillin-resistant clinical isolates of Streptococcus pneumoniae. Mol Microbiol. 1991 Aug;5(8):1993–2002. doi: 10.1111/j.1365-2958.1991.tb00821.x. [DOI] [PubMed] [Google Scholar]
  17. Liñares J., Alonso T., Pérez J. L., Ayats J., Domínguez M. A., Pallarés R., Martín R. Decreased susceptibility of penicillin-resistant pneumococci to twenty-four beta-lactam antibiotics. J Antimicrob Chemother. 1992 Sep;30(3):279–288. doi: 10.1093/jac/30.3.279. [DOI] [PubMed] [Google Scholar]
  18. Lonks J. R., Medeiros A. A. The growing threat of antibiotic-resistant Streptococcus pneumoniae. Med Clin North Am. 1995 May;79(3):523–535. doi: 10.1016/s0025-7125(16)30054-2. [DOI] [PubMed] [Google Scholar]
  19. Martin C., Sibold C., Hakenbeck R. Relatedness of penicillin-binding protein 1a genes from different clones of penicillin-resistant Streptococcus pneumoniae isolated in South Africa and Spain. EMBO J. 1992 Nov;11(11):3831–3836. doi: 10.1002/j.1460-2075.1992.tb05475.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. McDougal L. K., Facklam R., Reeves M., Hunter S., Swenson J. M., Hill B. C., Tenover F. C. Analysis of multiply antimicrobial-resistant isolates of Streptococcus pneumoniae from the United States. Antimicrob Agents Chemother. 1992 Oct;36(10):2176–2184. doi: 10.1128/aac.36.10.2176. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Pallares R., Liñares J., Vadillo M., Cabellos C., Manresa F., Viladrich P. F., Martin R., Gudiol F. Resistance to penicillin and cephalosporin and mortality from severe pneumococcal pneumonia in Barcelona, Spain. N Engl J Med. 1995 Aug 24;333(8):474–480. doi: 10.1056/NEJM199508243330802. [DOI] [PubMed] [Google Scholar]
  22. Petersson A. C., Miörner H. Species-specific identification of methicillin resistance in staphylococci. Eur J Clin Microbiol Infect Dis. 1995 Mar;14(3):206–211. doi: 10.1007/BF02310357. [DOI] [PubMed] [Google Scholar]
  23. Ploy M. C., Giamarellou H., Bourlioux P., Courvalin P., Lambert T. Detection of aac(6')-I genes in amikacin-resistant Acinetobacter spp. by PCR. Antimicrob Agents Chemother. 1994 Dec;38(12):2925–2928. doi: 10.1128/aac.38.12.2925. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Rahman M., Mauff G., Levy J., Couturier M., Pulverer G., Glasdorff N., Butzler J. P. Detection of 4-quinolone resistance mutation in gyrA gene of Shigella dysenteriae type 1 by PCR. Antimicrob Agents Chemother. 1994 Oct;38(10):2488–2491. doi: 10.1128/aac.38.10.2488. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Rudolph K. M., Parkinson A. J., Black C. M., Mayer L. W. Evaluation of polymerase chain reaction for diagnosis of pneumococcal pneumonia. J Clin Microbiol. 1993 Oct;31(10):2661–2666. doi: 10.1128/jcm.31.10.2661-2666.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Saruta K., Matsunaga T., Hoshina S., Kono M., Kitahara S., Kanemoto S., Sakai O., Machida K. Rapid identification of Streptococcus pneumoniae by PCR amplification of ribosomal DNA spacer region. FEMS Microbiol Lett. 1995 Oct 1;132(1-2):165–170. doi: 10.1111/j.1574-6968.1995.tb07827.x. [DOI] [PubMed] [Google Scholar]
  27. Tenover F. C., Huang M. B., Rasheed J. K., Persing D. H. Development of PCR assays to detect ampicillin resistance genes in cerebrospinal fluid samples containing Haemophilus influenzae. J Clin Microbiol. 1994 Nov;32(11):2729–2737. doi: 10.1128/jcm.32.11.2729-2737.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Ubukata K., Asahi Y., Yamane A., Konno M. Combinational detection of autolysin and penicillin-binding protein 2B genes of Streptococcus pneumoniae by PCR. J Clin Microbiol. 1996 Mar;34(3):592–596. doi: 10.1128/jcm.34.3.592-596.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Whelen A. C., Felmlee T. A., Hunt J. M., Williams D. L., Roberts G. D., Stockman L., Persing D. H. Direct genotypic detection of Mycobacterium tuberculosis rifampin resistance in clinical specimens by using single-tube heminested PCR. J Clin Microbiol. 1995 Mar;33(3):556–561. doi: 10.1128/jcm.33.3.556-561.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Zhang Y., Isaacman D. J., Wadowsky R. M., Rydquist-White J., Post J. C., Ehrlich G. D. Detection of Streptococcus pneumoniae in whole blood by PCR. J Clin Microbiol. 1995 Mar;33(3):596–601. doi: 10.1128/jcm.33.3.596-601.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Zighelboim S., Tomasz A. Penicillin-binding proteins of multiply antibiotic-resistant South African strains of Streptococcus pneumoniae. Antimicrob Agents Chemother. 1980 Mar;17(3):434–442. doi: 10.1128/aac.17.3.434. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Molecular Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES