Serotype 19F Multiresistant Pneumococcal Clone Harboring Two Erythromycin Resistance Determinants [ erm (B) and mef (A)] in South Africa

One hundred eighteen erythromycin-resistant Streptococcus pneumoniae (ERSP) strains (MICs of > or = 0.5 microg/ml) from five laboratories serving the private sector in South Africa were analyzed for the genes encoding resistance to macrolides. Sixty-seven ERSP strains (56.8%) contained the erm(B) gene, and 15 isolates (12.7%) contained the mef(A) gene. Thirty-six isolates (30.5%) harbored both the erm(B) and mef(A) genes and were highly resistant to erythromycin and clindamycin. DNA fingerprinting by BOX-PCR and pulsed-field gel electrophoresis identified 83% of these strains as belonging to a single multiresistant serotype 19F clone.