The Spain(14)-5 international multiresistant clone was initially described as resistant to penicillin, tetracycline, chloramphenicol and trimethoprim/sulfamethoxazole. In Gipuzkoa, Spain, Streptococcus pneumoniae isolated from 16 patients, and determined by PFGE and multilocus sequence typing to belong to the Spain(14)-5 clone, showed further resistance to fluoroquinolones (all strains had point mutations in the parC and gyrA genes). In addition, most strains showed resistance to amoxicillin (MIC > or = 8 mg/L), cefotaxime (MIC > or = 2 mg/L), macrolides and lincosamides. Two strains were resistant to rifampicin (MIC 8 mg/L). The multiresistance observed in these isolates converts the Spain(14)-5 clone into one of the most, if not the most, multiresistant of the international clones described.