K P Klugman

Summary

Affiliation: Emory University
Country: USA

Publications

  1. ncbi request reprint Streptococcus pneumoniae respiratory tract infections
    K P Klugman
    Wits MRC Pneumococcal Diseases Research Unit, School of Pathology, South African Institute for Medical Research and University of the Witwatersrand, South Africa
    Curr Opin Infect Dis 14:173-9. 2001
  2. ncbi request reprint A trial of a 9-valent pneumococcal conjugate vaccine in children with and those without HIV infection
    Keith P Klugman
    Medical Research Council, University of the Witwatersrand, National Institute for Communicable Diseases, Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa
    N Engl J Med 349:1341-8. 2003
  3. ncbi request reprint Bacteriological evidence of antibiotic failure in pneumococcal lower respiratory tract infections
    K P Klugman
    Dept of International Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA
    Eur Respir J Suppl 36:3s-8s. 2002
  4. ncbi request reprint Efficacy of pneumococcal conjugate vaccines and their effect on carriage and antimicrobial resistance
    K P Klugman
    Department of International Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
    Lancet Infect Dis 1:85-91. 2001
  5. ncbi request reprint The successful clone: the vector of dissemination of resistance in Streptococcus pneumoniae
    K P Klugman
    Department of International Health, Rollins School of Public Health, Division of Infectious Diseases, School of Medicine, Emory University, 1518 Clifton Road NE, Room 764, Atlanta, GA 30322, USA
    J Antimicrob Chemother 50:1-5. 2002
  6. ncbi request reprint The role of clonality in the global spread of fluoroquinolone-resistant bacteria
    Keith P Klugman
    Department of International Health, Rollins School of Public Health, Atlanta, GA, USA
    Clin Infect Dis 36:783-5. 2003
  7. pmc Rapid detection of penicillin-resistant Streptococcus pneumoniae in cerebrospinal fluid by a seminested-PCR strategy
    M du Plessis
    MRC, SAIMR, Wits, Pneumococcal Diseases Research Unit, Department of Medical Microbiology and School of Pathology, Johannesburg, South Africa
    J Clin Microbiol 36:453-7. 1998
  8. pmc Nomenclature of major antimicrobial-resistant clones of Streptococcus pneumoniae defined by the pneumococcal molecular epidemiology network
    L McGee
    MRC SAIMR Wits Pneumococcal Diseases Research Unit, Johannesburg, South Africa
    J Clin Microbiol 39:2565-71. 2001
  9. pmc Evernimicin (SCH27899) inhibits a novel ribosome target site: analysis of 23S ribosomal DNA mutants
    P V Adrian
    Pneumococcal Diseases Research Unit, South African Institute for Medical Research, University of the Witwatersrand, and the Medical Research Council, Johannesburg, South Africa
    Antimicrob Agents Chemother 44:3101-6. 2000
  10. pmc Emergence of the M phenotype of erythromycin-resistant pneumococci in South Africa
    C A Widdowson
    South African Institute for Medical Research, Johannesburg, South Africa
    Emerg Infect Dis 4:277-81. 1998

Collaborators

Detail Information

Publications119 found, 100 shown here

  1. ncbi request reprint Streptococcus pneumoniae respiratory tract infections
    K P Klugman
    Wits MRC Pneumococcal Diseases Research Unit, School of Pathology, South African Institute for Medical Research and University of the Witwatersrand, South Africa
    Curr Opin Infect Dis 14:173-9. 2001
    ..As resistant strains are more commonly associated with severe infections in patients with underlying disease, the interpretation of an association of resistance with poor clinical outcome is complicated...
  2. ncbi request reprint A trial of a 9-valent pneumococcal conjugate vaccine in children with and those without HIV infection
    Keith P Klugman
    Medical Research Council, University of the Witwatersrand, National Institute for Communicable Diseases, Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa
    N Engl J Med 349:1341-8. 2003
    ..We evaluated the efficacy of a 9-valent pneumococcal conjugate vaccine in a randomized, double-blind study in Soweto, South Africa...
  3. ncbi request reprint Bacteriological evidence of antibiotic failure in pneumococcal lower respiratory tract infections
    K P Klugman
    Dept of International Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA
    Eur Respir J Suppl 36:3s-8s. 2002
    ..High dose, active beta-lactams or fluoroquinolones with enhanced activity against Gram positive pathogens remain the drugs of choice for the management of community-acquired pneumonia caused by the drug-resistant pneumococcus...
  4. ncbi request reprint Efficacy of pneumococcal conjugate vaccines and their effect on carriage and antimicrobial resistance
    K P Klugman
    Department of International Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
    Lancet Infect Dis 1:85-91. 2001
    ..Studies are underway to assess conjugate vaccine efficacy against invasive disease, pneumonia, and all-cause mortality in developing countries, and to assess the potential use of these vaccines in adults...
  5. ncbi request reprint The successful clone: the vector of dissemination of resistance in Streptococcus pneumoniae
    K P Klugman
    Department of International Health, Rollins School of Public Health, Division of Infectious Diseases, School of Medicine, Emory University, 1518 Clifton Road NE, Room 764, Atlanta, GA 30322, USA
    J Antimicrob Chemother 50:1-5. 2002
    ..The molecular basis of resistance to a number of classes of antimicrobials can be used to predict the likelihood of dissemination of the resistance genes...
  6. ncbi request reprint The role of clonality in the global spread of fluoroquinolone-resistant bacteria
    Keith P Klugman
    Department of International Health, Rollins School of Public Health, Atlanta, GA, USA
    Clin Infect Dis 36:783-5. 2003
    ..Although these clones remain fluoroquinolone susceptible in children, their widespread distribution argues against the extension of fluoroquinolone use to the management of respiratory tract infection in children...
  7. pmc Rapid detection of penicillin-resistant Streptococcus pneumoniae in cerebrospinal fluid by a seminested-PCR strategy
    M du Plessis
    MRC, SAIMR, Wits, Pneumococcal Diseases Research Unit, Department of Medical Microbiology and School of Pathology, Johannesburg, South Africa
    J Clin Microbiol 36:453-7. 1998
    ..The positive predictive value and the negative predictive value of the assay were each 100%...
  8. pmc Nomenclature of major antimicrobial-resistant clones of Streptococcus pneumoniae defined by the pneumococcal molecular epidemiology network
    L McGee
    MRC SAIMR Wits Pneumococcal Diseases Research Unit, Johannesburg, South Africa
    J Clin Microbiol 39:2565-71. 2001
    ..This network can serve as a prototype for the collaboration of scientists in identifying clones of important human pathogens and as a model for the development of other networks...
  9. pmc Evernimicin (SCH27899) inhibits a novel ribosome target site: analysis of 23S ribosomal DNA mutants
    P V Adrian
    Pneumococcal Diseases Research Unit, South African Institute for Medical Research, University of the Witwatersrand, and the Medical Research Council, Johannesburg, South Africa
    Antimicrob Agents Chemother 44:3101-6. 2000
    ..Additionally, none of the characterized mutants showed cross-resistance to any of a spectrum of protein synthesis inhibitors, suggesting that the target site of evernimicin may be unique...
  10. pmc Emergence of the M phenotype of erythromycin-resistant pneumococci in South Africa
    C A Widdowson
    South African Institute for Medical Research, Johannesburg, South Africa
    Emerg Infect Dis 4:277-81. 1998
    ..These data suggest that, although macrolide resistance in pneumococci remains low in the public sector, the mefE gene is rapidly emerging in South Africa...
  11. pmc Fluoroquinolone resistance in invasive Streptococcus pyogenes isolates due to spontaneous mutation and horizontal gene transfer
    M W R Pletz
    Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
    Antimicrob Agents Chemother 50:943-8. 2006
    ..dysgalactiae. For the other isolate, we could confirm that it acquired resistance by spontaneous mutation by identifying the susceptible ancestor in an outbreak setting...
  12. pmc Alterations in PBP 1A essential-for high-level penicillin resistance in Streptococcus pneumoniae
    A M Smith
    MRC SAIMR Wits Pneumococcal Diseases Research Unit, Department of Clinical Microbiology and Infectious Diseases, South African Institute for Medical Research, Johannesburg, South Africa
    Antimicrob Agents Chemother 42:1329-33. 1998
    ..5 to 0.375 micrograms/ml. These data reveal that amino acid residue 371 and residues 574 to 577 of PBP 1A are important positions in PBP 1A with respect to the interaction with penicillin and the development of resistance...
  13. pmc Serotype 19f multiresistant pneumococcal clone harboring two erythromycin resistance determinants (erm(B) and mef(A)) in South Africa
    L McGee
    MRC SAIMR Wits Pneumococcal Diseases Research Unit, South African Institute for Medical Research, Johannesburg, South Africa
    Antimicrob Agents Chemother 45:1595-8. 2001
    ..DNA fingerprinting by BOX-PCR and pulsed-field gel electrophoresis identified 83% of these strains as belonging to a single multiresistant serotype 19F clone...
  14. ncbi request reprint Emergence of drug resistance. Impact on bacterial meningitis
    K P Klugman
    School of Pathology, South African Institute for Medical Research, University of the Witwatersrand, Johannesburg, South Africa
    Infect Dis Clin North Am 13:637-46, vii. 1999
    ..Correct management of these strains includes the addition of vancomycin or rifampin to therapy with third-generation cephalosporins...
  15. ncbi request reprint Concentration-dependent killing of antibiotic-resistant pneumococci by the methoxyquinolone moxifloxacin
    K P Klugman
    MRC SAIMR Wits Pneumococcal Diseases Research Unit, Johannesburg, South Africa
    J Antimicrob Chemother 40:797-802. 1997
    ..48-0.96 mg/L. These data suggest that orally administered moxifloxacin is likely to be highly active at physiological concentrations against penicillin- and macrolide-resistant pneumococci...
  16. pmc Emergence of a pneumococcal clone with cephalosporin resistance and penicillin susceptibility
    A M Smith
    MRC SAIMR Wits Pneumococcal Diseases Research Unit, Department of Clinical Microbiology and Infectious Diseases, South African Institute for Medical Research, Johannesburg, South Africa
    Antimicrob Agents Chemother 45:2648-50. 2001
    ..pbp 2X and 1A genes showed major alterations typical of cephalosporin-resistant pneumococci. The pbp 2B gene was completely unaltered, explaining the penicillin susceptibility of the isolates...
  17. ncbi request reprint Molecular basis and clonal nature of increasing pneumococcal macrolide resistance in South Africa, 2000-2005
    Nicole Wolter
    Respiratory and Meningeal Pathogens Research Unit, National Institute for Communicable Diseases, Medical Research Council and University of the Witwatersrand, Sandringham, South Africa
    Int J Antimicrob Agents 32:62-7. 2008
    ..Routine use of the 7-valent pneumococcal conjugate vaccine (PCV-7) could reduce the burden of macrolide-resistant pneumococcal disease in South Africa...
  18. doi request reprint Serotype 6C is associated with penicillin-susceptible meningeal infections in human immunodeficiency virus (HIV)-infected adults among invasive pneumococcal isolates previously identified as serotype 6A in South Africa
    Mignon du Plessis
    National Institute for Communicable Diseases, Sandringham, South Africa
    Int J Antimicrob Agents 32:S66-70. 2008
    ..Our data from the vaccine efficacy trial suggest that cross-protection of the conjugate vaccine is against true serotype 6A strains...
  19. pmc Novel expansions of the gene encoding dihydropteroate synthase in trimethoprim-sulfamethoxazole-resistant Streptococcus pneumoniae
    T Padayachee
    Pneumococcal Diseases Research Unit of the Medical Research Council, The South African Institute for Medical Research and The University of the Witwatersrand, Johannesburg, South Africa
    Antimicrob Agents Chemother 43:2225-30. 1999
    ..It is also proposed that the mechanism of sulfonamide resistance in S. pneumoniae involves the expansion of a specific region within dihydropteroate synthase, which probably forms part of the sulfonamide binding site...
  20. ncbi request reprint Management of community-acquired pneumonia in the era of pneumococcal resistance: a report from the Drug-Resistant Streptococcus pneumoniae Therapeutic Working Group
    J D Heffelfinger
    Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
    Arch Intern Med 160:1399-408. 2000
    ..To provide recommendations for the management of community-acquired pneumonia and the surveillance of drug-resistant Streptococcus pneumoniae (DRSP)...
  21. ncbi request reprint Antimicrobial resistance of nasopharyngeal isolates of Streptococcus pneumoniae and Haemophilus influenzae from children in the Central African Republic
    A K Rowe
    Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
    Pediatr Infect Dis J 19:438-44. 2000
    ..Secondary purposes of the survey were to identify risk factors associated with carriage of a resistant isolate and to compare the survey methods of including only children with pneumonia vs. including all ill children...
  22. pmc Molecular characterization of emerging non-levofloxacin-susceptible pneumococci isolated from children in South Africa
    Nicole Wolter
    Respiratory and Meningeal Pathogens Research Unit, National Institute for Communicable Diseases, Sandringham, Gauteng, South Africa
    J Clin Microbiol 47:1319-24. 2009
    ..These data suggest that a low-level non-levofloxacin-susceptible strain transformed into a highly resistant strain under antibiotic pressure and underwent capsular switching in order to have increased fitness...
  23. ncbi request reprint Five-year cohort study of hospitalization for respiratory syncytial virus associated lower respiratory tract infection in African children
    Shabir A Madhi
    University of the Witwatersrand Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Atlanta, GA, USA
    J Clin Virol 36:215-21. 2006
    ....
  24. ncbi request reprint Usefulness of C-reactive protein to define pneumococcal conjugate vaccine efficacy in the prevention of pneumonia
    Shabir A Madhi
    University of the Witwatersrand Medical Research Council National Institute of Communicable Diseases Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa
    Pediatr Infect Dis J 25:30-6. 2006
    ....
  25. pmc Use of procalcitonin and C-reactive protein to evaluate vaccine efficacy against pneumonia
    Shabir A Madhi
    National Health Laboratory Service, University of the Witwatersrand, Johannesburg, South Africa
    PLoS Med 2:e38. 2005
    ..The poor specificity of chest radiographs (CXRs) to diagnose pneumococcal pneumonia may underestimate the efficacy of pneumococcal conjugate vaccine in preventing pneumococcal pneumonia...
  26. ncbi request reprint In-vitro and in-vivo activity of trovafloxacin against Streptococcus pneumoniae
    K P Klugman
    Department of Medical Microbiology, South African Institute for Medical Research and University of the Witwatersrand, Johannesburg
    J Antimicrob Chemother 39:51-5. 1997
    ..Trovafloxacin was also highly efficacious in a rabbit pneumococcal meningitis model. These data suggest that the clinical efficacy of trovafloxacin against pneumococci should be evaluated further...
  27. ncbi request reprint Increased carriage of trimethoprim/sulfamethoxazole-resistant Streptococcus pneumoniae in Malawian children after treatment for malaria with sulfadoxine/pyrimethamine
    D R Feikin
    Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
    J Infect Dis 181:1501-5. 2000
    ..7% at the 4-week follow-up. Expanding use of sulfadoxine/pyrimethamine to treat chloroquine-resistant malaria may have implications for national pneumonia programs in developing countries where cotrimoxazole is widely used...
  28. pmc Mutations in ribosomal protein L16 conferring reduced susceptibility to evernimicin (SCH27899): implications for mechanism of action
    P V Adrian
    Pneumococcal Diseases Research Unit of the South African Institute for Medical Research, University of the Witwatersrand and the Medical Research Council, Johannesburg, South Africa
    Antimicrob Agents Chemother 44:732-8. 2000
    ..The incorporation of isoleucine showed a linear response to the dose level of evernimicin. The incorporation of other classes of labeled substrates was unaffected or much delayed, indicating that these were secondary effects...
  29. pmc Molecular basis of rifampin resistance in Streptococcus pneumoniae
    T Padayachee
    Pneumococcal Diseases Research Unit of the MRC, SAIMR, and the University of the Witwatersrand, Johannesburg, South Africa
    Antimicrob Agents Chemother 43:2361-5. 1999
    ..pneumoniae to resistance. Although many of the isolates studied displayed identical sequences, pulsed-field gel electrophoresis analysis revealed that the isolates were not of clonal origin...
  30. pmc An unusual pneumococcal sequence type is the predominant cause of serotype 3 invasive disease in South Africa
    Kedibone M Mothibeli
    Respiratory and Meningeal Pathogens Research Unit, National Institute for Communicable Diseases, Medical Research Council, University of the Witwatersrand, Johannesburg, South Africa
    J Clin Microbiol 48:184-91. 2010
    ..We have therefore identified ST458 as predominating in South Africa, but with an invasive potential similar to that of the predominant global clone ST180...
  31. ncbi request reprint Ciprofloxacin treatment failure in a patient with resistant Streptococcus pneumoniae infection following prior ciprofloxacin therapy
    M W R Pletz
    Department of International Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA
    Eur J Clin Microbiol Infect Dis 24:58-60. 2005
    ..This report of treatment failure due to ciprofloxacin-resistant Streptococcus pneumoniae shows that fluoroquinolones should be avoided when treating patients who have recently received this class of antibiotics...
  32. ncbi request reprint Community-acquired pneumonia: new management strategies for evolving pathogens and antimicrobial susceptibilities
    K P Klugman
    Department of International Health, Rollins School of Public Health and Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA, USA
    Int J Antimicrob Agents 24:411-22. 2004
    ..New guidelines from the IDSA attempt to embrace these changes...
  33. ncbi request reprint Bacteremic pneumococcal pneumonia in HIV-seropositive and HIV-seronegative adults
    C Feldman
    Department of Medicine, Hillbrow Hospital, University of the Witwatersrand, Johannesburg, South Africa
    Chest 116:107-14. 1999
    ..To compare the demographic, clinical, laboratory, and microbiological data, and the hospital course and outcome of HIV-seropositive and HIV-seronegative adults with bacteremic pneumococcal pneumonia...
  34. ncbi request reprint Penicillin- and cephalosporin-resistant Streptococcus pneumoniae. Emerging treatment for an emerging problem
    K P Klugman
    Department of Clinical Microbiology and Infectious Diseases, South African Institute for Medical Research, Johannesburg, South Africa
    Drugs 58:1-4. 1999
    ..The new fluoroquinolones with excellent antipneumococcal activity may be considered for use in the setting of pneumonia caused by highly resistant pneumococci and are under evaluation for the management of meningitis...
  35. pmc Alterations in MurM, a cell wall muropeptide branching enzyme, increase high-level penicillin and cephalosporin resistance in Streptococcus pneumoniae
    A M Smith
    Pneumococcal Diseases Research Unit, Department of Clinical Microbiology and Infectious Diseases, South African Institute for Medical Research, Johannesburg, South Africa
    Antimicrob Agents Chemother 45:2393-6. 2001
    ..Penicillin-binding protein DNA was insufficient to transform recipient strain R6 to full resistance. Further transformation with altered murM DNA was required for full expression of donor penicillin and cefotaxime resistance...
  36. doi request reprint Severity of illness scoring systems in patients with bacteraemic pneumococcal pneumonia: implications for the intensive care unit care
    C Feldman
    Division of Pulmonology, Department of Medicine, Charlotte Maxeke Johannesburg Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa
    Clin Microbiol Infect 15:850-7. 2009
    ..The low PPV of the PSI rendered it not usable as a parameter for decision-making in severely-ill patients with pneumococcal bacteraemia...
  37. ncbi request reprint Trends in antimicrobial resistance and serotype distribution of blood and cerebrospinal fluid isolates of Streptococcus pneumoniae in South Africa, 1991-1998
    - Huebner RE
    Medical Research Council, South African Institute for Medical Research, University of the Witwatersrand, Pneumococcal Diseases Research Unit, Johannesburg 2000, South Africa
    Int J Infect Dis 4:214-8. 2000
    ..This study documents trends in antimicrobial resistance in pneumococci isolated from blood or cerebrospinal fluid (CSF) between 1991 and 1998 in South Africa...
  38. ncbi request reprint Long-term immunogenicity and efficacy of a 9-valent conjugate pneumococcal vaccine in human immunodeficient virus infected and non-infected children in the absence of a booster dose of vaccine
    Shabir A Madhi
    University of the Witwatersrand Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, South Africa
    Vaccine 25:2451-7. 2007
    ..2microg/ml to vaccine-serotypes analyzed compared to HIV infected vaccinees at 5.3 years of age...
  39. doi request reprint Emergence of levofloxacin-non-susceptible Streptococcus pneumoniae and treatment for multidrug-resistant tuberculosis in children in South Africa: a cohort observational surveillance study
    Anne Von Gottberg
    National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
    Lancet 371:1108-13. 2008
    ..Our aim was to estimate the incidence of, and risk factors for, invasive pneumococcal disease caused by fluoroquinolone-resistant Streptococcus pneumoniae in children in South Africa...
  40. pmc Emergence of Streptococcus pneumoniae with very-high-level resistance to penicillin
    Stephanie J Schrag
    Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
    Antimicrob Agents Chemother 48:3016-23. 2004
    ..The emergence, clonality, and association of very-high-level penicillin resistance with multiple drug resistance requires further monitoring and highlights the need for novel agents active against the pneumococcus...
  41. ncbi request reprint The impact of a 9-valent pneumococcal conjugate vaccine on the public health burden of pneumonia in HIV-infected and -uninfected children
    Shabir A Madhi
    National Health Laboratory Service, University of the Witwatersrand, Johannesburg, South Africa
    Clin Infect Dis 40:1511-8. 2005
    ..Pneumococcal conjugate vaccine (PnCV) may be used as a probe to define the burden of pneumococcal disease and better characterize the clinical presentation of pneumococcal pneumonia...
  42. ncbi request reprint Risk factors for antibiotic resistance in Streptococcus pneumoniae
    K P Klugman
    Rollins School of Public Health, Emory University, Atlanta, USA
    S Afr Med J 97:1129-32. 2007
    ..Conjugate pneumococcal vaccine affords protection from resistant strains belonging to vaccine serotypes, but resistance is emerging in non-vaccine types...
  43. pmc Use of a rapid test of pneumococcal colonization density to diagnose pneumococcal pneumonia
    W C Albrich
    Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa
    Clin Infect Dis 54:601-9. 2012
    ..We therefore tested a quantitative lytA real-time polymerase chain reaction (rtPCR) on NP swab samples from patients with pneumonia and controls...
  44. ncbi request reprint Association of serotypes of Streptococcus pneumoniae with disease severity and outcome in adults: an international study
    S R J Alanee
    Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
    Clin Infect Dis 45:46-51. 2007
    ....
  45. pmc Cerebrospinal fluid bactericidal activity against cephalosporin-resistant Streptococcus pneumoniae in children with meningitis treated with high-dosage cefotaxime
    I R Friedland
    Department of Pediatrics, Baragwanath Hospital, and The University of Witwatersrand, Johannesburg, South Africa
    Antimicrob Agents Chemother 41:1888-91. 1997
    ..High-dose cefotaxime, while safe, is not reliably sufficient therapy for cephalosporin-nonsusceptible pneumococcal meningitis, and combination therapy is recommended...
  46. pmc New gene cassettes for trimethoprim resistance, dfr13, and Streptomycin-spectinomycin resistance, aadA4, inserted on a class 1 integron
    P V Adrian
    Department of Medical Microbiology, University of the Witwatersrand, and the South African Institute for Medical Research, Johannesburg, South Africa
    Antimicrob Agents Chemother 44:355-61. 2000
    ....
  47. pmc Altered PBP 2A and its role in the development of penicillin, cefotaxime, and ceftriaxone resistance in a clinical isolate of Streptococcus pneumoniae
    Anthony M Smith
    MRC NICD WITS Respiratory and Meningeal Pathogens Research Unit, National Institute for Communicable Diseases, P O Box 1038, Johannesburg 2000, South Africa
    Antimicrob Agents Chemother 49:2002-7. 2005
    ..In all likelihood, these events produced a strain which evolved into a fitter and more virulent type, isolate 3, that resulted in an aggravated pneumococcal infection and ultimately in the patient's death...
  48. pmc Interspecies recombination in type II topoisomerase genes is not a major cause of fluoroquinolone resistance in invasive Streptococcus pneumoniae isolates in the United States
    Mathias W R Pletz
    Department of International Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA
    Antimicrob Agents Chemother 49:779-80. 2005
    ..We analyzed the nucleotide sequences of the quinolone resistance-determining regions of 49 invasive levofloxacin-resistant pneumococcal isolates and did not find any evidence for interspecies recombination...
  49. pmc Heterogeneous macrolide resistance and gene conversion in the pneumococcus
    Nicole Wolter
    Respiratory and Meningeal Pathogens Research Unit, National Institute for Communicable Diseases, Private Bag X4, Sandringham, 2131, South Africa
    Antimicrob Agents Chemother 50:359-61. 2006
    ..These data explain the disappearance on subculture of heterogeneous macrolide resistance in the pneumococcus...
  50. pmc Fitness costs of fluoroquinolone resistance in Streptococcus pneumoniae
    Daniel E Rozen
    Department of Biology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
    Antimicrob Agents Chemother 51:412-6. 2007
    ..We discuss the implications of these results for the epidemiology of fluoroquinolone resistance and the evolution of acquired resistance in treated patients...
  51. pmc Hidden epidemic of macrolide-resistant pneumococci
    Keith P Klugman
    Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA
    Emerg Infect Dis 11:802-7. 2005
    ..We provide an overview of macrolide-resistant S. pneumoniae and assess the impact of this resistance on the empiric treatment of community-acquired RTIs...
  52. ncbi request reprint Pneumococcal vaccination in developing countries
    Orin S Levine
    Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Lancet 367:1880-2. 2006
  53. doi request reprint Pneumococcal pneumonia and influenza: a deadly combination
    Keith P Klugman
    Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
    Vaccine 27:C9-C14. 2009
    ..Vaccination with PCV for children and pneumococcal polysaccharide vaccine for adults should be considered essential to pandemic influenza preparedness...
  54. pmc In vitro evaluation of the antimicrobial activity of ceftaroline against cephalosporin-resistant isolates of Streptococcus pneumoniae
    Lesley McGee
    Emory University, Atlanta, Georgia 30322, USA
    Antimicrob Agents Chemother 53:552-6. 2009
    ..pneumoniae strains resistant to existing parenteral cephalosporins and support its continued development for the treatment of infections caused by resistant S. pneumoniae strains...
  55. doi request reprint Novel approaches to the identification of Streptococcus pneumoniae as the cause of community-acquired pneumonia
    Keith P Klugman
    Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA
    Clin Infect Dis 47:S202-6. 2008
    ....
  56. ncbi request reprint Seasonality, incidence, and repeat human metapneumovirus lower respiratory tract infections in an area with a high prevalence of human immunodeficiency virus type-1 infection
    Shabir A Madhi
    University of the Witwatersrand Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Chris Hani Baragwanath Hospital, Bertsham, South Africa
    Pediatr Infect Dis J 26:693-9. 2007
    ..There is limited information regarding the epidemiology of human metapneumovirus (hMPV) from Africa, despite it being identified as a common pathogen in children with pneumonia...
  57. ncbi request reprint Resurgence of the multiresistant pneumococcus in the United States: a commentary
    Keith P Klugman
    Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
    Pediatr Infect Dis J 26:473-4. 2007
  58. ncbi request reprint Clinical impact of antibiotic resistance in respiratory tract infections
    Keith P Klugman
    Hubert Department of Global Health, Rollins School of Public Health, and Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA 30322, USA
    Int J Antimicrob Agents 29:S6-10. 2007
    ..pneumoniae present numerous clinical challenges, and require carefully selected treatment strategies to preserve antibacterial efficacy. Antibiotics with a low propensity for stimulating resistance should be chosen wherever possible...
  59. pmc High-level telithromycin resistance in a clinical isolate of Streptococcus pneumoniae
    Nicole Wolter
    Respiratory and Meningeal Pathogens Research Unit, National Institute for Communicable Diseases, Medical Research Council and University of the Witwatersrand, Johannesburg, South Africa
    Antimicrob Agents Chemother 51:1092-5. 2007
    ..By transformation of susceptible strains, this study shows that high-level telithromycin resistance is conferred by erm(B), wild type or mutant, in combination with a (69)GTG(71)-to-TPS mutation in ribosomal protein L4...
  60. ncbi request reprint HIV and pneumococcal disease
    Keith P Klugman
    Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA
    Curr Opin Infect Dis 20:11-5. 2007
    ..To describe the impact of highly active antiretroviral therapy on the burden of pneumococcal disease and advances in our understanding of the impact of HIV on this disease...
  61. ncbi request reprint Pneumonia vaccines for all who need them
    Keith P Klugman
    William H Foege Chair in Global Health, Rollins School of Public Health, Atlanta, GA, USA
    Hum Vaccin 5:779-80. 2009
    ....
  62. ncbi request reprint Vaccines as tools against resistance: the example of pneumococcal conjugate vaccine
    Cynthia G Whitney
    Epidemiology Section, Respiratory Diseases Branch, Division of Bacterial and Mycotic Disease, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS C23, Atlanta, GA 30333, USA
    Semin Pediatr Infect Dis 15:86-93. 2004
    ..Surveillance is needed to monitor the spread of antimicrobial resistance into nonvaccine serotypes, which may lead to a resurgence of resistance...
  63. ncbi request reprint Antibiotic resistance and serotype distribution of Streptococcus pneumoniae colonizing rural Malawian children
    Daniel R Feikin
    Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, PHS DHHS, 1600 Clifton Road, Mailstop C23, Atlanta, GA 30333, USA
    Pediatr Infect Dis J 22:564-7. 2003
    ..Forty-three percent of isolates were serotypes included in the 7-valent pneumococcal conjugate vaccine, and 37% were vaccine-related serotypes, particularly 6A and 19A...
  64. ncbi request reprint Gender as a risk factor for both antibiotic resistance and infection with pediatric serogroups/serotypes, in HIV-infected and -uninfected adults with pneumococcal bacteremia
    Kimberly A Buie
    Department of International Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA
    J Infect Dis 189:1996-2000. 2004
    ..25-2.36]) than were men. Thus, conjugate pneumococcal vaccination of children may reduce, in particular, both antibiotic resistance and the burden of conjugate vaccine serotype pneumococcal disease in young, HIV-infected women...
  65. ncbi request reprint Susceptibility of Bacillus anthracis to eleven antimicrobial agents including novel fluoroquinolones and a ketolide
    John Frean
    National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
    J Antimicrob Chemother 52:297-9. 2003
    ..To determine the susceptibility of southern African strains of Bacillus anthracis to new, investigational agents as well as conventional antibiotics...
  66. pmc Levofloxacin-resistant invasive Streptococcus pneumoniae in the United States: evidence for clonal spread and the impact of conjugate pneumococcal vaccine
    Mathias W R Pletz
    Department of International Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA
    Antimicrob Agents Chemother 48:3491-7. 2004
    ..Our results suggest that invasive pneumococcal isolates resistant to levofloxacin in the United States show considerable evidence of multiple resistance and of clonal spread...
  67. pmc Neisseria meningitidis intermediately resistant to penicillin and causing invasive disease in South Africa in 2001 to 2005
    Mignon du Plessis
    National Institute for Communicable Diseases of the National Health Laboratory Service, University of the Witwatersrand, Johannesburg, South Africa
    J Clin Microbiol 46:3208-14. 2008
    ..This is the first report describing the prevalence and molecular epidemiology of Pen(i) meningococcal isolates from sub-Saharan Africa...
  68. ncbi request reprint Oral antibiotics for the treatment of severe pneumonia in children
    Keith P Klugman
    Respiratory and Meningeal Pathogens Research Unit, Medical Research Council, University of the Witwatersrand, National Health Laboratory Service, Johannesburg, South Africa
    Lancet 364:1104-5. 2004
  69. doi request reprint Timing of serotype 1 pneumococcal disease suggests the need for evaluation of a booster dose
    K P Klugman
    Respiratory and Meningeal Pathogens Research Unit, Medical Research Council, University of Witwatersrand, Johannesburg, South Africa
    Vaccine 29:3372-3. 2011
    ..These data suggest that a booster dose given at 9 months of age, or early in the second year of life, should be evaluated for protection against type 1 pneumococcal disease...
  70. pmc New trimethoprim-resistant dihydrofolate reductase cassette, dfrXV, inserted in a class 1 integron
    P V Adrian
    Department of Medical Microbiology, University of the Witwatersrand, and the South African Institute for Medical Research, Johannesburg, South Africa
    Antimicrob Agents Chemother 42:2221-4. 1998
    ..Genes for spectinomycin resistance, aadA1 [ant (3")-Ia], and sulfonamide resistance, sulI, were located downstream of dfrXV in a manner identical to that in pLMO229...
  71. ncbi request reprint Long-term effect of pneumococcal conjugate vaccine on nasopharyngeal colonization by Streptococcus pneumoniae--and associated interactions with Staphylococcus aureus and Haemophilus influenzae colonization--in HIV-Infected and HIV-uninfected children
    Shabir A Madhi
    University of the Witwatersrand Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Bertsham, South Africa
    J Infect Dis 196:1662-6. 2007
    ..aureus and colonization by H. influenzae were observed only in HIV-uninfected children, possibly as a result of suboptimal adaptive immunity after previous colonization in HIV-infected children...
  72. pmc Prevalence of first-step mutants among levofloxacin-susceptible invasive isolates of Streptococcus pneumoniae in the United States
    Mathias W R Pletz
    Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
    Antimicrob Agents Chemother 50:1561-3. 2006
    ..Among those with a levofloxacin MIC of 2 mg/liter, 16.2% of isolates recovered from nursing home residents and 6.4% from non-nursing home residents had first-step mutations...
  73. ncbi request reprint Pneumococcal coinfection with human metapneumovirus
    Shabir A Madhi
    University of the Witwatersrand Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Bertsham, South Africa
    J Infect Dis 193:1236-43. 2006
    ..Infection with the newly discovered human metapneumovirus (hMPV) may lead to hospitalization of children with lower respiratory tract infection (LRTI), although the pathogenesis thereof remains to be elucidated...
  74. ncbi request reprint Emergence of fluoroquinolone-resistant Streptococcus pneumoniae in a South African child in a tuberculosis treatment facility
    Anne Von Gottberg
    Respiratory and Memingeal Pathogens Research Unit, Medical Research Council, University of the Witwatersrand, National Institute for Communicable Diseases, Johannesburg, South Africa
    Pediatr Infect Dis J 22:1020-1. 2003
  75. ncbi request reprint Bacteraemic pneumococcal pneumonia: impact of HIV on clinical presentation and outcome
    Charles Feldman
    Division of Pulmonology, Department of Medicine, Johannesburg Hospital, University of the Witwatersrand, Medical School, 7 York Road, Parktown 2193, Johannesburg, South Africa
    J Infect 55:125-35. 2007
    ....
  76. ncbi request reprint Fluoroquinolone resistance among clinical isolates of Streptococcus pneumoniae belonging to international multiresistant clones
    Lesley McGee
    Pneumococcal Diseases Research Unit of the Medical Research Council, The South African Institute for Medical Research and The University of the Witwatersrand, Johannesburg, South Africa
    J Antimicrob Chemother 49:173-6. 2002
    ....
  77. pmc Telithromycin resistance in Streptococcus pneumoniae is conferred by a deletion in the leader sequence of erm(B) that increases rRNA methylation
    Nicole Wolter
    Respiratory and Meningeal Pathogens Research Unit, National Institute for Communicable Diseases, Private Bag X4, Sandringham 2131, South Africa
    Antimicrob Agents Chemother 52:435-40. 2008
    ..Elevated erm(B) expression results in a higher level of rRNA methylation that presumably hinders telithromycin binding to the ribosome...
  78. ncbi request reprint Quantitative and qualitative antibody response to pneumococcal conjugate vaccine among African human immunodeficiency virus-infected and uninfected children
    Shabir A Madhi
    National Institute of Communicable Diseases University of the Witwatersrand Medical Research Council Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa
    Pediatr Infect Dis J 24:410-6. 2005
    ..To determine the quantitative and qualitative antibody responses to a pneumococcal conjugate vaccine (PnCV) in human immunodeficiency virus (HIV)-exposed infected and uninfected children...
  79. ncbi request reprint Historical changes in pneumococcal serogroup distribution: implications for the era of pneumococcal conjugate vaccines
    Daniel R Feikin
    Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
    Clin Infect Dis 35:547-55. 2002
    ..These historical trends in serogroup distribution may be explained by changes in antibiotic use, socioeconomic conditions, the immunocompromised status of populations, and blood-culturing practices...
  80. pmc Novel mechanism of resistance to oxazolidinones, macrolides, and chloramphenicol in ribosomal protein L4 of the pneumococcus
    Nicole Wolter
    Respiratory and Meningeal Pathogens Research Unit, National Institute for Communicable Diseases, P O Box 1038, Johannesburg, 2000, South Africa
    Antimicrob Agents Chemother 49:3554-7. 2005
    ..We demonstrate a novel bacterial mechanism of resistance to chloramphenicol and nonsusceptibility to linezolid...
  81. ncbi request reprint Immunogenicity after one, two or three doses and impact on the antibody response to coadministered antigens of a nonavalent pneumococcal conjugate vaccine in infants of Soweto, South Africa
    Robin E Huebner
    MRS NHLS Wits Pneumococcal Diseases Research Unit, Johannesburg, South Africa
    Pediatr Infect Dis J 21:1004-7. 2002
    ..Children <6 months of age are at increased risk of pneumococcal disease. The early immunogenicity of conjugate vaccines therefore may be important to prevent disease in young children...
  82. pmc Mutations within the rplD Gene of Linezolid-Nonsusceptible Streptococcus pneumoniae Strains Isolated in the United States
    W Dong
    Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
    Antimicrob Agents Chemother 58:2459-62. 2014
    ..Our study identified mutations and deletions near the linezolid binding pocket of two of these strains within the rplD gene, which encodes ribosomal protein L4. Mutations in the 23S rRNA alleles or the rplV gene were not detected. ..
  83. ncbi request reprint Recommendations for treatment of childhood non-severe pneumonia
    Gavin B Grant
    National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention CDC, Atlanta, GA 30333, USA
    Lancet Infect Dis 9:185-96. 2009
    ..If failure of the first-line agent remains a possible explanation, suitable second-line agents include high-dose amoxicillin-clavulanic acid with or without an affordable macrolide for children over 3 years of age...
  84. ncbi request reprint Immunogenicity and effectiveness of Haemophilus influenzae type b conjugate vaccine in HIV infected and uninfected African children
    Shabir A Madhi
    University of the Witwatersrand, Medical Research Council Respiratory and Meningeal Pathogens Research Unit, South Africa
    Vaccine 23:5517-25. 2005
    ..001). The estimated risk of HibCV failure was 35.1-fold greater (95% CI 14.6-84.6) amongst HIV infected than HIV uninfected children...
  85. ncbi request reprint Implications for antimicrobial prescribing of strategies based on bacterial eradication
    Keith P Klugman
    Department of International Health, Rollins School of Public Health, Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA 30322, USA
    Int J Infect Dis 7:S27-31. 2003
    ..To maximize clinical cure and minimize the emergence and spread of resistance, antimicrobial prescribing should maximize bacterial eradication, and clinical drug evaluation needs to be brought into line with this need...
  86. doi request reprint Quantitative and qualitative anamnestic immune responses to pneumococcal conjugate vaccine in HIV-infected and HIV-uninfected children 5 years after vaccination
    Shabir A Madhi
    Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand Medical Research Council, Johannesburg, South Africa
    J Infect Dis 199:1168-76. 2009
    ..e., previous vaccinees) and in those receiving their first dose of vaccine (i.e., control subjects)...
  87. pmc Amino acid mutations essential to production of an altered PBP 2X conferring high-level beta-lactam resistance in a clinical isolate of Streptococcus pneumoniae
    Anthony M Smith
    Respiratory and Meningeal Pathogens Research Unit, National Institute for Communicable Diseases, Medical Research Council, Johannesburg, South Africa
    Antimicrob Agents Chemother 49:4622-7. 2005
    ..Our data reveal that, for isolate 3191, the six amino acid substitutions described above are collectively essential to the production of an altered PBP 2X required for high-level resistance to penicillin and cefotaxime...
  88. ncbi request reprint World Health Organisation definition of "radiologically-confirmed pneumonia" may under-estimate the true public health value of conjugate pneumococcal vaccines
    Shabir A Madhi
    University of the Witwatersrand Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, South Africa
    Vaccine 25:2413-9. 2007
    ....
  89. ncbi request reprint Increased prevalence of pediatric pneumococcal serotypes in elderly adults
    Daniel R Feikin
    Division of Bacterial and Mycotic Diseases, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
    Clin Infect Dis 41:481-7. 2005
    ..Pneumococcal disease is most prevalent among young children and elderly adults. We explored whether similarities exist in the serotypes that cause disease in these 2 high-risk groups...
  90. ncbi request reprint Human metapneumovirus-associated lower respiratory tract infections among hospitalized human immunodeficiency virus type 1 (HIV-1)-infected and HIV-1-uninfected African infants
    Shabir A Madhi
    National Institute for Communicable Diseases University of the Witwatersrand Medical Research Council Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa
    Clin Infect Dis 37:1705-10. 2003
    ..1-fold more common than parainfluenza virus types 1-3. Genotyping of 7 of 14 isolates revealed the circulation of 2 major phylogenetic groups of the virus, which were similar to those described in North America and Europe...
  91. ncbi request reprint Impact of haemophilus influenzae type b conjugate vaccine in South Africa and Argentina
    Michael Martin
    Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
    Pediatr Infect Dis J 23:842-7. 2004
    ..Because surveillance for culture-confirmed Hib meningitis is not available in many countries, alternative means to measure the impact of Hib conjugate vaccine would be useful...
  92. pmc Mutations in the dihydrofolate reductase gene of trimethoprim-resistant isolates of Streptococcus pneumoniae
    P V Adrian
    Pneumococcal Diseases Research Unit of South African Institute for Medical Research, University of the Witwatersrand, and Medical Research Council, Johannesburg
    Antimicrob Agents Chemother 41:2406-13. 1997
    ....
  93. ncbi request reprint Lower respiratory tract infections associated with influenza A and B viruses in an area with a high prevalence of pediatric human immunodeficiency type 1 infection
    Shabir A Madhi
    University of the Witwatersrand Medical Research Council Pneumococcal Diseases Rearch Unit, Johannesburg, South Africa
    Pediatr Infect Dis J 21:291-7. 2002
    ..Despite the high burden of pediatric HIV-1 infection in developing countries, there are few data on the clinical course of influenza virus-associated lower respiratory tract infection (LRTI) in these children...
  94. pmc Site-specific mutagenesis analysis of PBP 1A from a penicillin-cephalosporin-resistant pneumococcal isolate
    Anthony M Smith
    Respiratory and Meningeal Pathogens Research Unit, Department of Clinical Microbiology and Infectious Diseases, National Health Laboratory Service, Johannesburg, South Africa
    Antimicrob Agents Chemother 47:387-9. 2003
    ..Our data reveal that mutations at amino acid positions 574 to 577 and position 539 cause penicillin and cefotaxime resistance...
  95. ncbi request reprint Bacterial aetiology of non-resolving otitis media in South African children
    Robin E Huebner
    Respiratory and Meningeal Pathogens Research Unit of the MRC NHLS University of the Witwatersrand, Johannesburg, South Africa
    J Laryngol Otol 117:169-72. 2003
    ....
  96. ncbi request reprint Antibiotic prescribing practices for common childhood illnesses in South Africa
    Robin E Huebner
    MRC Respiratory and Meningeal, Pathogens Research Unit, University of the Witwatersrand, National Health Laboratory Service, Johannesburg
    S Afr Med J 93:505-8. 2003
  97. ncbi request reprint Reduced effectiveness of Haemophilus influenzae type b conjugate vaccine in children with a high prevalence of human immunodeficiency virus type 1 infection
    Shabir A Madhi
    NHLS Wits MRC Pneumococcal Diseases Research Unit, University of Witwatersrand, Johannesburg, South Africa
    Pediatr Infect Dis J 21:315-21. 2002
    ..Haemophilus influenzae type b (Hib) conjugate vaccines have successfully reduced the burden of invasive Hib disease in developed countries; however, their effectiveness in countries with a high incidence of pediatric HIV-1 is unknown...
  98. pmc Effect of HIV infection status and anti-retroviral treatment on quantitative and qualitative antibody responses to pneumococcal conjugate vaccine in infants
    Shabir A Madhi
    Department of Science National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
    J Infect Dis 202:355-61. 2010
    ..Nevertheless, M-/I- infants had superior OPA responses, compared with those in HIV+/ART+ infants, who in turn had better OPA responses, compared with those in HIV+/ART- infants...
  99. ncbi request reprint Susceptibility of Yersinia pestis to novel and conventional antimicrobial agents
    John Frean
    National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
    J Antimicrob Chemother 52:294-6. 2003
    ..To determine the susceptibility of southern African strains of Yersinia pestis to novel as well as conventional antimicrobial agents...
  100. pmc Identification of the tetracycline resistance gene, tet(O), in Streptococcus pneumoniae
    C A Widdowson
    MRC SAIMR Wits Pneumococcal Diseases Research Unit, South African Institute for Medical Research, Hillbrow, Johannesburg, South Africa
    Antimicrob Agents Chemother 40:2891-3. 1996
    ....
  101. pmc Emergence and spread of Streptococcus pneumoniae with erm(B) and mef(A) resistance
    David J Farrell
    G R Micro Ltd, London, United Kingdom
    Emerg Infect Dis 11:851-8. 2005
    ..3% were CC271, with the highest prevalence seen in South Africa, South Korea, and the United States. This study confirms the increasing global emergence and rapidly increasing US prevalence of this multidrug-resistant pneumococcal clone...