Predicting Pneumococcus Resistance to β-lactam Antibiotics

Minimum Inhibitory Concentrations Predicted by Penicillin Binding Protein Gene Types

Key points

  • CDC's Streptococcus Laboratory created procedures to predict phenotypic susceptibility results for multiple antibiotics using whole-genome sequencing data.
  • For beta (β)-lactam antibiotics, the procedure uses penicillin binding protein (PBP) types.

Overview

PBP types are based on transpeptidase-encoding regions of PBP proteins 1a, 2b, and 2x.

Laboratory personnel can use a machine-learning algorithm to predict a specific level of resistance based on a S. pneumoniae isolate's PBP gene type1234.

Reference resources

Streptococcus pneumoniae pipeline

Minimum inhibitory concentrations and algorithm

PBP type sequence databases

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Content Source:
National Center for Immunization and Respiratory Diseases; Division of Bacterial Diseases
  1. Metcalf BJ, Gertz RE Jr, Gladstone RA, et al. Strain features and distributions in pneumococci from children with invasive disease before and after 13-valent conjugate vaccine implementation in the USA. Clin Microbiol Infect. 2016;22(1):60 e9–60.
  2. Metcalf BJ, Chochua S, Gertz RE Jr, et al. Using whole genome sequencing to identify resistance determinants and predict antimicrobial resistance phenotypes for year 2015 invasive pneumococcal disease isolates recovered in the United States. Clin Microbiol Infect. 2016;22(12):1002.e1–1002.e8.
  3. CDC Streptococcus Laboratory bioinformatic pipelines for S. agalactiae, S. pyogenes, and S. pneumoniae.
  4. Li Y, Metcalf BJ, Chochua S, et al. Penicillin-binding protein transpeptidase signatures for tracking and predicting β-lactam resistance levels in Streptococcus pneumoniae. mBio. 2016;7(3):60 pii:e00756–16.