Penicillin resistance among Streptococcus pneumoniae isolates has rapidly
emerged in Poland during the last decade and has reached prevalence levels
of up to 14.4% in 1997. In order to investigate the nature of this
increase, a molecular epidemiological analysis of
non-penicillin-susceptible multidrug-resistant pneumococci isolated in
1995 and 1996 was conducted. Thirty-seven patients who suffered mainly
from upper respiratory tract infections and pneumococcal pneumonia were
enrolled in this study. The medical centers to which the patients were
admitted were located in 16 Polish towns across the country. Eight
distinct BOX PCR types were observed, representing 14 subtypes.
Restriction fragment end labeling (RFEL) analysis divided the pneumococcal
strains into 16 distinct types. By combining the BOX PCR and RFEL data,
four genetically distinct clusters of strains were identified. Two
clusters represented the genetic clones 23F and 9V, which have recently
emerged all over the world. The two other genetic clusters, which
represented serotypes 23F and 6B, clearly predominated in the analyzed
collection of Polish non-penicillin-susceptible pneumococcal strains.
Since the latter clusters did not match any of the 133 RFEL types of
non-penicillin-susceptible pneumococci collected in 15 other countries,
their Polish clonal origin is most likely
