Hsieh Y.-C.LUAN-YIN CHANGHuang Y.-C.Lin H.-C.LI-MIN HUANGPO-REN HSUEH2020-03-272020-03-2720101198-743Xhttps://scholars.lib.ntu.edu.tw/handle/123456789/480148Levofloxacin susceptibility testing was carried out for a total of 2539 Streptococcus pneumoniae isolates obtained from January 2001 to February 2008 at the National Taiwan University Hospital (NTUH) and a further 228 pneumococcal isolates obtained from January 2004 to December 2006 at three other hospitals in different geographical areas in Taiwan. Levofloxacin non-susceptible S. pneumoniae isolates were subsequently analysed for serotype and molecular epidemiology. Rates of levofloxacin non-susceptibility of S. pneumoniae increased significantly from 1.2% in 2001 to 4.2% in 2007 at NTUH. A total of 30 isolates of levofloxacin non-susceptible S. pneumoniae isolates (MIC ? 4 mg/L) were available for evaluation of serotype, antimicrobial susceptibility, nucleotide sequence of the quinolone resistance-determining regions of parC, gyrA, parE and gyrB, reserpine effect on quinolone susceptibility and multilocus sequence type. Among these isolates, seven (23.3%) were from children, and two (6.7%; one from a 3- and one from a 93-year-old patient) were from blood. One levofloxacin-resistant isolate (MIC = 8 mg/L) was recovered from a previously healthy child with bacteraemic necrotizing pneumonia complicated by empyema and a haemolytic-uraemic syndrome. All isolates except two had Ser79 and/or Asp83 changes in ParC, and/or Ser81 or Glu85 changes in GyrA. An efflux phenotype concerning levofloxacin was detected in only one (3.3%) isolate. A novel clone (ST3642), genetically related to Spain9V-3 and belonging to serotype 11A, was identified. Dissemination of clonal complexes related to Spain23F-1, Taiwan19F-14, Spain9V-3 and Taiwan23F-15 has contributed to levofloxacin non-susceptibility among these S. pneumoniae isolates from Taiwan. ? 2009 The Authors. Journal Compilation ? 2009 European Society of Clinical Microbiology and Infectious Diseases.[SDGs]SDG3ciprofloxacin; DNA topoisomerase (ATP hydrolysing) A; DNA topoisomerase (ATP hydrolysing) B; gatifloxacin; gemifloxacin; levofloxacin; moxifloxacin; ofloxacin; protein ParC; protein ParE; quinoline derived antiinfective agent; reserpine; trovafloxacin; aged; amino acid substitution; antibiotic resistance; antibiotic sensitivity; article; bacterial pneumonia; bacterial transmission; bacterium isolate; child; clone; controlled study; empyema; hemolytic uremic syndrome; human; minimum inhibitory concentration; molecular epidemiology; multilocus sequence typing; nonhuman; nucleotide sequence; phenotype; priority journal; sequence analysis; serotype; Spain; Streptococcus pneumoniae; Taiwan; Streptococcus pneumoniaejournal article10.1111/j.1469-0691.2009.02951.x197782982-s2.0-77954631466