Antimicrobial Susceptibility of Streptococcus pneumoniae in Eight European Countries from 2001 to 2003

ABSTRACT Susceptibility testing results for Streptococcus pneumoniae isolates (n = 2,279) from eight European countries, examined in the PneumoWorld Study from 2001 to 2003, are presented. Overall, 24.6% of S. pneumoniae isolates were nonsusceptible to penicillin G and 28.0% were resistant to macrolides. The prevalence of resistance varied widely between European countries, with the highest rates of penicillin G and macrolide resistance reported from Spain and France. Serotype 14 was the leading serotype among penicillin G- and macrolide-resistant S. pneumoniae isolates. One strain (PW 158) showed a combination of an efflux type of resistance with a 23S rRNA mutation (A2061G, pneumococcal numbering; A2059G, Escherichia coli numbering). Six strains which showed negative results for mef(A) and erm(B) in repeated PCR assays had mutations in 23S rRNA or alterations in the L4 ribosomal protein (two strains). Fluoroquinolone resistance rates (levofloxacin MIC ≥ 4 μg/ml) were low (Austria, 0%; Belgium, 0.7%; France, 0.9%; Germany, 0.4%; Italy, 1.3%; Portugal, 1.2%; Spain, 1.0%; and Switzerland, 0%). Analysis of quinolone resistance-determining regions showed eight strains with a Ser81 alteration in gyrA; 13 of 18 strains showed a Ser79 alteration in parC. The clonal profile, as analyzed by multilocus sequence typing (MLST), showed that the 18 fluoroquinolone-resistant strains were genetically heterogeneous. Seven of the 18 strains belonged to new sequence types not hitherto described in the MLST database. Europe-wide surveillance for monitoring of the further spread of these antibiotic-resistant S. pneumoniae clones is warranted.

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Molecular Epidemiology of Staphylococcus epidermidis Clinical Isolates from U.S. Hospitals

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00279-12 ◽

2012 ◽

Vol 56 (9) ◽

pp. 4656-4661 ◽

Cited By ~ 45

Author(s):

Rodrigo E. Mendes ◽

Lalitagauri M. Deshpande ◽

Andrew J. Costello ◽

David J. Farrell

Keyword(s):

Staphylococcus Epidermidis ◽

Resistance Mechanisms ◽

23S Rrna ◽

Content Type ◽

Linezolid Resistance ◽

Clonal Distribution ◽

Resistant Strains ◽

Resistance Rates ◽

Susceptibility Profiles ◽

Sequence Types

ABSTRACTThe epidemiology ofStaphylococcus epidermidisin U.S. hospitals remains limited. This study aimed to address the genetic backgrounds of linezolid-susceptible and -resistantS. epidermidisstrains (isolated in 2010), includingcfr-carrying strains. In addition, the antimicrobial susceptibility profiles and linezolid resistance mechanisms among clonal lineages were assessed. A total of 71S. epidermidisisolates were selected, and linezolid-resistant strains were screened forcfrand mutations in 23S rRNA, L3, and L4. All isolates were subjected to multilocus sequence typing (MLST), and the results were analyzed by eBURST. Overall, 27 sequence types (STs) were detected, and ST5 (21.1%) and ST2 (16.9%) predominated. The majority (62/71; 87.3%) of STs belonged to clonal complex 2 (CC2), which was mostly comprised of subclusters CC2-II (41/62; 66.1%) and CC2-I (21/62; 33.9%). Other STs were grouped within CC23 or CC32 or were singletons. CC2-I strains were more likely to display a methicillin (95.2% versus 33.3 to 70.7%), a linezolid (47.6% versus 0.0 to 7.3%), or a multidrug (81.0% versus 33.3 to 36.6%) resistance phenotype. Among linezolid-resistant isolates,cfrwas noted only within CC2 strains, and it was detected equally in the CC2-I (3/10; 30.0%) and CC2-II (1/3; 33.3%) subclusters. 23S rRNA mutations (G2576 [seven strains] and C2534 [one strain]) were observed only among CC2-I (8/10; 80.0%) isolates. Strains showing a G2576 alteration also had M156 (7/7; 100.0%) and/or H146 (6/7; 85.7%) L3 modifications. This study provides an overview of theS. epidermidisclonal distribution and reports higher resistance rates among CC2-I strains. The results show thatcfrmay be acquired and expressed by both CC2 main subclusters, while 23S rRNA mutations appeared more often within CC2-I strains. Interestingly, these 23S rRNA mutants also had L3 alterations, which may act synergistically or in a compensatory manner to minimize the fitness cost while providing survival advantages under selective pressure.

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Phenotypic and molecular characterization of macrolide resistance mechanisms among Streptococcus pneumoniae isolated in Tunisia

Journal of Medical Microbiology ◽

10.1099/jmm.0.001151 ◽

2020 ◽

Vol 69 (4) ◽

pp. 505-520 ◽

Cited By ~ 1

Author(s):

B. Midouni Ayadi ◽

E. Mehiri ◽

H. Draoui ◽

A. Ghariani ◽

L. Essalah ◽

...

Keyword(s):

Streptococcus Pneumoniae ◽

Type Species ◽

Resistance Mechanisms ◽

Macrolide Resistance ◽

23S Rrna ◽

Serotype Distribution ◽

Antibiotic Resistant ◽

Content Type ◽

Link Type ◽

Resistant Strains

Introduction. Streptococcus pneumoniae is responsible for many community infections, with the main ones being pneumonia and meningitis. Pneumococcus has developed increased resistance to multiple classes of antibiotics. The evolution of antibiotic resistance in pneumococcus was influenced by changes in serotype distribution under vaccine selection pressure. Aim. The aim of this study was to determine the genes involved in macrolide resistance, the antimicrobial susceptibility, the serotype distribution and the spread of international antibiotic-resistant clones among clinical isolates of S. pneumoniae . Methodology. We investigated 86 erythromycin-resistant S. pneumoniae strains isolated from respiratory (n=74) or non-respiratory (n=12) samples in Tunisia. Antimicrobial susceptibility was tested using the disk diffusion method. Macrolide-resistant strains were analysed by polymerase chain reaction (PCR) for ermA, ermB, mefA and msrD. We also investigated the macrolide resistance mechanisms in eight isolates (9.3%) by sequencing the L4 and L22 riboprotein-coding genes, plus relevant segments of the three 23S rRNA genes. Capsular serotypes were detected by multiplex PCR. Sequence types (STs) were explored using multilocus sequence typing (MLST). Results. Among the 86 studied strains, 70 (81.4 %) were resistant to penicillin G. The prevalent serotypes were 19F, 14, 19A and 23F. We observed that the cMLSB phenotype (66/86, 76.7%) was the most common in these pneumococci. In addition, ermB was the most frequent resistance gene. No mutation in ribosomal protein L22 or L4 or 23S rRNA was detected. Overall, 44 STs were identified in this study, including 16 that were described for the first time. Resistance to lincomycin, tetracycline and trimethoprim/sulfamethoxazole was observed in 55 (64 %), 34 (39.5 %) and 31 (36 %) isolates, respectively. Furthermore, an increase in fluoroquinolone use in particular may lead to the emergence of levofloxacin-resistant strains. Multidrug resistance was observed in 83 isolates (96.5%). Three global antibiotic-resistant clones were identified: Denmark14 ST230, Portugal19F ST177 and Spain9V ST156. Conclusion. This study shows that macrolide resistance among S. pneumoniae isolated in Tunisia is mainly related to target site modification. Our observations demonstrate a high degree of genetic diversity and capsular types among strains resistant to macrolides.

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Streptococcus pneumoniae carriage in school children

Medical alphabet ◽

10.33667/2078-5631-2021-30-57-60 ◽

2021 ◽

Vol 1 (30) ◽

pp. 57-60

Author(s):

I. N. Protasova ◽

N. V. Bakhareva ◽

N. A. Ilyenkova ◽

E. S. Sokolovskaya ◽

T. A. Elistratova ◽

...

Keyword(s):

Streptococcus Pneumoniae ◽

Antimicrobial Resistance ◽

School Children ◽

Clonal Diversity ◽

Multidrug Resistant ◽

Clonal Structure ◽

Serotype Distribution ◽

Antibiotic Resistant ◽

Oropharyngeal Swab ◽

Resistant Strains

Purpose. To investigate the serotype distribution, clonal structure and antimicrobial resistance of pneumococci isolated from schoolchildren.Materials and methods. During the period from 2012 to 2018 we examined 498 healthy school children aged 6 to 17 years. Oropharyngeal swab was taken from each child for culture, after that all S. pneumoniae strains were genotyped for serotype and ST-type deduction (PCR and sequencing, respectively). Antimicrobial resistance was also determined.Results. Pneumococcal culture was positive in 10.6 % of children. S. pneumoniae isolates belonged to seven serogroups and seven serotypes. Serogroup 6 and serotype 19F strains (15.1% each), and serogroup 9 strains (13.2%) were the most prevalent. S. pneumoniae33FA/37 and 3 (9.4 and 5.7%), serogroups 15 and 18 (7.6 and 5.7%), and 10A serotype (3.8%) were determined at a lower frequency. 20 detected ST-types belonged to 14 clonal complexes (CCs); CC156, CC447, and CC320 were predominant. 1.9% of isolates were penicillin-resistant; 13.2% – macrolide-, clindamycin-, and tetracycline-resistant. S. pneumoniae antibiotic resistant strains belonged to multidrug-resistant CCs 320, 315, and 156.Conclusion. S. pneumoniae prevalence in school children is not high. Pneumococcal population is characterized by serotype and clonal diversity including ‘invasive’ serotypes and genotypes. Most of strains are susceptible to antimicrobials.

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Macrolide-resistant phenotypes of invasive streptococcus pneumoniae isolates in Serbia

Archives of Biological Sciences ◽

10.2298/abs1204377g ◽

2012 ◽

Vol 64 (4) ◽

pp. 1377-1382

Author(s):

Ina Gajic ◽

Natasa Opavski ◽

Vera Mijac ◽

L. Ranin

Keyword(s):

Streptococcus Pneumoniae ◽

Susceptibility Testing ◽

Reference Laboratory ◽

National Reference ◽

The Past ◽

Triple Test ◽

Resistance To Penicillin ◽

Resistant Strains ◽

Resistance Rates ◽

Susceptibility Patterns

Macrolide resistance in Streptococcus pneumoniae has emerged as an important worldwide problem over the past decade. The aim of this study was to investigate macrolide-resistant phenotypes and the antimicrobial susceptibility patterns of invasive pneumococci in Serbia. A total of 68 invasive pneumococcal strains, collected from 2009 to 2011, were sent from regional laboratories to the National Reference Laboratory. Susceptibility testing was performed using the VITEK2 system and phenotypes were determined by triple-test. Overall penicillin and erythromycin nonsusceptibility rates were 26% and 43%, respectively. Resistance rates were higher in children than in adults. Co-resistance to penicillin and erythromycin was detected in 18% strains. Resistance rates to the third generation of cephalosporins, TMP-SXT and tetracycline were 16%, 37% and 29%, respectively. All isolates were fully susceptible to vancomycin, linezolid, fluoroquinolones, telithromycin and rifampicin. Twenty-two isolates (79%) an expressed macrolide-lincosamide-streptogramin B (MLSB) resistance phenotype and M phenotype was found in 21% of macrolide resistant strains.

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Antistreptococcal Activity of Telithromycin Compared with Seven Other Drugs in Relation to Macrolide Resistance Mechanisms in Russia

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.46.9.2963-2968.2002 ◽

2002 ◽

Vol 46 (9) ◽

pp. 2963-2968 ◽

Cited By ~ 26

Author(s):

Roman S. Kozlov ◽

Tatiana M. Bogdanovitch ◽

Peter C. Appelbaum ◽

Lois Ednie ◽

Leonid S. Stratchounski ◽

...

Keyword(s):

Streptococcus Pneumoniae ◽

Ribosomal Protein ◽

Streptococcus Pyogenes ◽

Prevalence Rate ◽

Resistance Mechanism ◽

Resistance Mechanisms ◽

Macrolide Resistance ◽

Penicillin G ◽

23S Rrna

ABSTRACT The susceptibilities of 468 recent Russian clinical Streptococcus pneumoniae isolates and 600 Streptococcus pyogenes isolates, from 14 centers in Russia, to telithromycin, erythromycin, azithromycin, clarithromycin, clindamycin, levofloxacin, quinupristin-dalfopristin, and penicillin G were tested. Penicillin-nonsusceptible S. pneumoniae strains were rare except in Siberia, where their prevalence rate was 13.5%: most were penicillin intermediate, but for three strains (two from Smolensk and one from Novosibirsk) the MICs of penicillin G were 4 or 8 μg/ml. Overall, 2.5% of S. pneumoniae isolates were resistant to erythromycin. Efflux was the prevalent resistance mechanism (five strains; 41.7%), followed by ribosomal methylation encoded by constitutive erm(B), which was found in four isolates. Ribosomal mutation was the mechanism of macrolide resistance in three isolates; one erythromycin-resistant S. pneumoniae isolate had an A2059G mutation in 23S rRNA, and two isolates had substitution of GTG by TPS at positions 69 to 71 in ribosomal protein L4. All S. pyogenes isolates were susceptible to penicillin, and 11% were erythromycin resistant. Ribosomal methylation was the most common resistance mechanism for S. pyogenes (89.4%). These methylases were encoded by erm(A) [subclass erm(TR)] genes, and their expression was inducible in 96.6% of isolates. The rest of the erythromycin-resistant Russian S. pyogenes isolates (7.6%) had an efflux resistance mechanism. Telithromycin was active against 100% of pneumococci and 99.2% of S. pyogenes, and levofloxacin and quinupristin-dalfopristin were active against all isolates of both species.

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Responses of Wild-Type and Resistant Strains of the Hyperthermophilic Bacterium Thermotoga maritima to Chloramphenicol Challenge

Applied and Environmental Microbiology ◽

10.1128/aem.00453-07 ◽

2007 ◽

Vol 73 (15) ◽

pp. 5058-5065 ◽

Cited By ~ 11

Author(s):

Clemente I. Montero ◽

Matthew R. Johnson ◽

Chung-Jung Chou ◽

Shannon B. Conners ◽

Sarah G. Geouge ◽

...

Keyword(s):

Thermotoga Maritima ◽

23S Rrna ◽

Spontaneous Mutant ◽

Wild Type ◽

Antibiotic Resistant ◽

Mesophilic Bacteria ◽

Hyperthermophilic Bacterium ◽

Resistant Strains ◽

Type Response

ABSTRACT Transcriptomes and growth physiologies of the hyperthermophile Thermotoga maritima and an antibiotic-resistant spontaneous mutant were compared prior to and following exposure to chloramphenicol. While the wild-type response was similar to that of mesophilic bacteria, reduced susceptibility of the mutant was attributed to five mutations in 23S rRNA and phenotypic preconditioning to chloramphenicol.

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Antipneumococcal Activity of ABT-773 Compared to Those of 10 Other Agents

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.44.7.1894-1899.2000 ◽

2000 ◽

Vol 44 (7) ◽

pp. 1894-1899 ◽

Cited By ~ 36

Author(s):

Todd A. Davies ◽

Lois M. Ednie ◽

Dianne M. Hoellman ◽

Glenn A. Pankuch ◽

Michael R. Jacobs ◽

...

Keyword(s):

Ribosomal Protein ◽

Vitro Activity ◽

Penicillin Resistance ◽

Penicillin G ◽

23S Rrna ◽

In Vitro Activity ◽

Resistant Strains ◽

Domain V ◽

Kinetics Of

ABSTRACT MICs, time-kills, and postantibiotic effects (PAEs) of ABT-773 (a new ketolide) and 10 other agents were determined against 226 pneumococci. Against 78 ermB- and 44mefE-containing strains, ABT-773 MICs at which 50% of the isolates tested were inhibited (MIC50s) and MIC90s were 0.016 to 0.03 and 0.125 μg/ml, respectively. Clindamycin was active only against macrolide-resistant strains containing mefE (MIC50, 0.06 μg/ml; MIC90, 0.125 μg/ml). Activities of pristinamycin (MIC90, 0.5 μg/ml) and vancomycin (MIC90, 0.25 μg/ml) were unaffected by macrolide or penicillin resistance, while β-lactam MICs rose with those of penicillin G. Against 19 strains with L4 ribosomal protein mutations and two strains with mutations in domain V of 23S rRNA, ABT-773 MICs were 0.03 to 0.25 μg/ml, while macrolide and azalide MICs were all ≥16.0 μg/ml. ABT-773 was bactericidal at twice the MIC after 24 h for 8 of 12 strains (including three strains with erythromycin MICs greater than or equal to 64.0 μg/ml). Kill kinetics of erythromycin, azithromycin, clarithromycin, and roxithromycin against macrolide-susceptible strains were slower than those of ABT-773. ABT-773 had longer PAEs than macrolides, azithromycin, clindamycin, or β-lactams, including against ermB-containing strains. ABT-773, therefore, shows promising in vitro activity against macrolide-susceptible as well as -resistant pneumococci.

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In Vitro Selection of Resistance to Four β-Lactams and Azithromycin in Streptococcus pneumoniae

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.42.11.2914 ◽

1998 ◽

Vol 42 (11) ◽

pp. 2914-2918 ◽

Cited By ~ 48

Author(s):

Glenn A. Pankuch ◽

Shane A. Jueneman ◽

Todd A. Davies ◽

Michael R. Jacobs ◽

Peter C. Appelbaum

Keyword(s):

Streptococcus Pneumoniae ◽

In Vitro Selection ◽

Antimicrobial Agents ◽

Penicillin G ◽

Resistance Selection ◽

Resistant Strains ◽

Selection Of ◽

Selection Of Resistance

ABSTRACT Selection of resistance to amoxicillin (with or without clavulanate), cefaclor, cefuroxime, and azithromycin among six penicillin G- and azithromycin-susceptible pneumococcal strains and among four strains with intermediate penicillin sensitivities (azithromycin MICs, 0.125 to 4 μg/ml) was studied by performing 50 sequential subcultures in medium with sub-MICs of these antimicrobial agents. For only one of the six penicillin-susceptible strains did subculturing in medium with amoxicillin (with or without clavulanate) lead to an increased MIC, with the MIC rising from 0.008 to 0.125 μg/ml. Five of the six penicillin-susceptible strains showed increased azithromycin MICs (0.5 to >256.0 μg/ml) after 17 to 45 subcultures. Subculturing in medium with cefaclor did not affect the cefaclor MICs of three strains but and led to increased cefaclor MICs (from 0.5 to 2.0 to 4.0 μg/ml) for three of the six strains, with MICs of other β-lactams rising 1 to 3 twofold dilutions. Subculturing in cefuroxime led to increased cefuroxime MICs (from 0.03 to 0.06 μg/ml to 0.125 to 0.5 μg/ml) for all six strains without significantly altering the MICs of other β-lactams, except for one strain, which developed an increased cefaclor MIC. Subculturing in azithromycin did not affect β-lactam MICs. Subculturing of the four strains with decreased penicillin susceptibility in amoxicillin (with or without clavulanate) or cefuroxime did not select for β-lactam resistance. Subculturing of one strain in cefaclor led to an increase in MIC from 0.5 to 2.0 μg/ml after 19 passages. In contrast to strains that were initially azithromycin susceptible, which required >10 subcultures for resistance selection, three of four strains with azithromycin MICs of 0.125 to 4.0 μg/ml showed increased MICs after 7 to 13 passages, with the MICs increasing to 16 to 32 μg/ml. All azithromycin-resistant strains were clarithromycin resistant. With the exception of strains that contained mefE at the onset, no strains that developed resistance to azithromycin containedermB or mefE, genes that have been found in macrolide-resistant pneumococci obtained from clinic patients.

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Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae causing invasive diseases in China: a meta-analysis

BMC Pediatrics ◽

10.1186/s12887-019-1722-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Jinjian Fu ◽

Rongsong Yi ◽

Yongjiang Jiang ◽

Shaolin Xu ◽

Peixu Qin ◽

...

Keyword(s):

Streptococcus Pneumoniae ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Mainland China ◽

Antibiotic Resistant ◽

Effect Model ◽

Resistance To Penicillin ◽

Resistance Rates

Abstract Background To summarize information about invasive pneumococcal disease (IPD) among children in mainland China. Methods Sixteen eligible studies were included in this systematic review and the random effect model was used to estimate the pool prevalence of IPD. Results The most predominant serotypes circulating in children were 19F (27.7, 95% confidence interval (95% CI): 17.7–37.6%), 19A (21.2%, 16.4–26.1%), 14 (16.5%, 12.8–20.1%), 6B (8.6%, 5.2–10.8%) and 23F (7.3%, 5.2–9.5%). The serotype coverage of the available pneumococcal conjugate vaccines PCV7, PCV10, and PCV13 was 60.8% (52.5–69.4%), 65.1% (57.7–72.4%), and 90.0% (87.1–92.8%), respectively. The pooled antibiotic resistance rates of Streptococcus pneumoniae revealed a resistance to penicillin prevalence rate of 32.0% (12.1–51.9%). Approximately 94.4% (90.7–98.1%) and 92.3% (87.4–97.3%) of isolates were resistant to erythromycin and clindamycin. eBURST analysis revealed great diversity among isolates, with 102 sequence types (STs) for 365 isolates. The major predominant clonal complexes (CCs) were CC271 (43.6%, 159/365), CC876 (13.4%, 49/365), CC81 (5.2%, 19/365), and CC90 (4.1%, 15/365). Long-term and regional surveillance of S. pneumoniae is necessary. Conclusions Based on our pooled results showing that PCV13 coverage of the reported serotypes was 90% and that most serotypes contributed to the distribution of antibiotic-resistant isolates, implementation of PCV13 into the Chinese Expanded Program on Immunizations (EPI) would achieve health benefits in Chinese children.

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Risk factors for development of Streptococcus pneumoniae resistance to antibiotics

Practical medicine ◽

10.32000/2072-1757-2020-6-113-118 ◽

2020 ◽

Vol 18 (6) ◽

pp. 113-118

Author(s):

S. A. SEMENOV ◽

◽

G. R. KHASANOVA ◽

Keyword(s):

Risk Factors ◽

Streptococcus Pneumoniae ◽

Empirical Therapy ◽

Pneumococcal Infections ◽

Term Care ◽

Antibiotic Resistant ◽

Resistance To Antibiotics ◽

Wide Range ◽

Potential Risk Factors ◽

Resistant Strains

Streptococcus pneumoniae is responsible for a wide range of human diseases, often with a severe course and prognosis. The growing resistance of pneumococci to certain classes of antibiotics limits the treatment of pneumococcal infections. The study of factors that influence the formation of antibiotic resistance of the pathogen is important for developing a strategy to counter this phenomenon and for predicting the presence of microbial resistance in a particular patient when choosing a drug for empirical therapy. This review presents the results of studies of some potential risk factors for the formation of Streptococcus pneumoniae resistance to antibiotics. The most important of these is the previous administration of antibiotics, especially in the last few months. Previous diseases, previous hospitalization, and the nosocomial nature of pneumonia are also considered as factors that allow predicting the colonization of loci by antibiotic-resistant strains of pneumococci. Staying at long-term care facilities and attending organized groups (schools and kindergartens) may also increase the risk of colonization of the respiratory tract by antibiotic-resistant strains of pneumococci. The frequency of isolation of pneumococcus strains insensitive to certain antibiotics is also characterized by wide geographical variability.

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