Ardanuy, Carmende la Campa, Adela GGarcía, ErnestoFenoll, AsuncionCalatayud, LauraCercenado, EmiliaPérez-Trallero, EmilioBouza, EmilioLiñares, Josefina2021-04-272021-04-272014-11Emerg Infect Dis. 2014 Nov;20(11):1848-56.1080-6040http://hdl.handle.net/20.500.12105/12783Since 2004, a total of 131 isolates of Streptococcus pneumoniae multidrug-resistant invasive serotype 8 have been detected in Spain. These isolates showed resistance to erythromycin, clindamycin, tetracycline, and ciprofloxacin. All isolates were obtained from adult patients and shared a common genotype (sequence type [ST]63; penicillin-binding protein 1a [pbp1a], pbp2b, and pbp2x gene profiles; ermB and tetM genes; and a ParC-S79F change). Sixty-eight isolates that required a ciprofloxacin MIC ≥16 μg/mL had additional gyrA gene changes. Serotype 8-ST63 pbp2x sequences were identical with those of antimicrobial drug-susceptible serotype 8-ST53 isolates. Serotype 8-ST63 pbp2b sequences were identical with those of the multidrug-resistant Sweden 15A-ST63 clone. Recombination between the capsular locus and flanking regions of an ST53 isolate (donor) and an ST63 pneumococcus (recipient) generated the novel 15A-ST63 clone. One recombination point was upstream of pbp2x and another was within pbp1a. A serotype 8-ST63 clone was identified as a cause of invasive disease in Spain.engVoRhttp://creativecommons.org/licenses/by/4.0/Drug Resistance, Multiple, BacterialRecombination, GeneticAdolescentAdultAmino Acid SequenceAnti-Bacterial AgentsBacterial ProteinsBase SequenceChildCodonGene OrderGenome, BacterialGenotypeHumansMicrobial Sensitivity TestsMolecular Sequence DataMolecular TypingPhenotypePneumococcal InfectionsPolymorphism, GeneticSerogroupSpainStreptococcus pneumoniaeYoung AdultAtribución 4.0 Internacional2534061620111848-5610.3201/eid2011.1312151080-6059Emerging infectious diseasesopen access