Characterisation of the main clones of Streptococcus pyogenes carrying the ermA (subclass TR) gene in Spain

Montes, Milagrosa; Orden, Beatriz; Tamayo, Esther; Alós, Juan-Ignacio; Pérez-Trallero, Emilio

doi:10.1016/j.ijantimicag.2006.08.013

Cited by 9 publications

(6 citation statements)

References 28 publications

(32 reference statements)

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“…However, we did not detect any significant distribution in macrolide or tetracycline-resistant isolates. The heterogeneity of emm types among macrolide-resistant and tetracycline-resistant isolates in the present study is compatible with some reports 37 and contrasts with the others 14,19,26,27,30,39 . Montes et al reported an association between emm77 and tet(M).…”

Section: Discussionsupporting

confidence: 91%

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Macrolide and Tetracycline Resistance andemmType Distribution ofStreptococcus pyogenesIsolates Recovered from Turkish Patients

Dündar

Sayan

Tamer

2010

Microbial Drug Resistance

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The aims of this study were to determine the susceptibilities to macrolide and tetracycline antibiotics and emm type distribution of Streptococcus pyogenes strains isolated in the Kocaeli University Hospital, Turkey. A total of 127 S. pyogenes clinical isolates were tested. Eleven (9%) isolates were resistant to erythromycin, and 23 (18%) isolates were resistant to tetracycline. Ten of the erythromycin-resistant isolates were also resistant to tetracycline. By the triple-disk test, all erythromycin-resistant isolates showed the inducible macrolide-lincosamidestreptogramin-C phenotype and harbored erm(TR) gene. tet(O) was the most common tetracycline resistance gene. Among erythromycin-tetracycline coresistant isolates, seven harbored the tet(O) gene. emm 4, emm 1, emm 2,114, and emm 89 were the most common emm types. These isolates were more susceptible to erythromycin. There was considerable emm type heterogeneity in macrolide or tetracycline resistant isolates. According to our knowledge, this is the first study in which emm type distribution is investigated in Turkey. More comprehensive studies are needed to obtain true information about the epidemiology of macrolide and tetracycline resistance and emm type distribution in Turkey.

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Section: Discussionsupporting

confidence: 91%

“…They also reported that the emm22 isolates were the most frequent clone among the inducible resistant isolates in Spain. 27 Green et al reported that emm75 and emm12 accounted for more than half of the macrolide-resistant isolates. 19 Fluctuations in the serotype distribution over time were also reported.…”

Section: Discussionmentioning

confidence: 99%

Macrolide and Tetracycline Resistance andemmType Distribution ofStreptococcus pyogenesIsolates Recovered from Turkish Patients

Dündar

Sayan

Tamer

2010

Microbial Drug Resistance

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“…These findings are in concert with a report of an outbreak of invasive infections in a nursing home in which emm11 was one of two distinct emm types identified in the outbreak (26). An emm11 strain expressing the ermA gene was identified in Spain (17). Nevertheless, 10 emm types (types 1,6,11,12,13,22,33,77,92, and 101) were covered by the 26-valent GAS vaccine (12).…”

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confidence: 81%

Changing Epidemiology of Streptococcus pyogenes emm Types and Associated Invasive and Noninvasive Infections in Southern Taiwan

Wang²,

Lin

et al. 2009

J Clin Microbiol

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“…The PFGE pattern of the ST369 isolate showed Ͼ80% similarity with the patterns of other ST63 isolates. A more detailed description of this clone has previously been described (24).…”

Section: Resultsmentioning

confidence: 99%

Phenotypic and Genotypic Characterization of Streptococcus pyogenes Isolates Displaying the MLS _B Phenotype of Macrolide Resistance in Spain, 1999 to 2005

Pérez-Trallero

Montes

Orden³

et al. 2007

Antimicrob Agents Chemother

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The aim of this study was to describe the genetic characteristics of Streptococcus pyogenes showing the MLS B phenotype of macrolide resistance from 1999 to 2005 in Spain and to highlight the substantial increase in these isolates in the last few years. The antimicrobial susceptibilities of 17,232 group A streptococci isolated from Madrid and Gipuzkoa from 1999 to 2005 were studied. The presence of the resistance genes ermA, ermB, mef, tetM, and tetO and the presence of the intTn and xis genes of the Tn916-Tn1545 transposon family were studied in a sample of 739 MLS B -resistant isolates. The epidemiological relationships among these isolates were analyzed by emm typing, T typing, and multilocus sequence typing. Erythromycin resistance was found in 21.3% of the isolates analyzed (annual variation of 14.3% to 28.9%). Until 2003, most erythromycin-resistant isolates showed the M phenotype, but in 2004 and 2005, about 50% of isolates showed the MLS B phenotype. Among the MLS B -resistant isolates studied, 16 clones were identified. The most prevalent clone was a strange emm11/ T11/ST403 clone with a null yqiL allele. All but one of the 463 emm11/T11/ST403 isolates carried the ermB, tetM, intTn, and xis genes. The second most prevalent MLS B -resistant clone was emm28/T28/ST52, which comprised two subclones: one bacitracin-resistant, tetracycline-susceptible subclone carrying the ermB gene (n ‫؍‬ 115) and another bacitracin-susceptible, tetracycline-resistant subclone carrying the ermB and tetM genes (n ‫؍‬ 33). The rapid diffusion of these two clones, and especially of emm11/T11/ST403, caused the large increase in MLS Bresistant S. pyogenes isolates in Spain, suggesting a potential ability for international dissemination.Streptococcus pyogenes is a pathogen with worldwide distribution that causes a broad spectrum of infections, from uncomplicated pharyngitis to severe life-threatening infections (6). In the absence of a ␤-lactam allergy, the treatment of choice is penicillin, while the first-line alternative treatments are macrolides or lincosamides. There are two main phenotypes of macrolide resistance: the M phenotype, mediated by the mef genes (8), which confer low-level resistance to 14-and 15-membered macrolides but not to 16-membered macrolides, lincosamides, or streptogramin B, and the MLS B phenotype, mediated by the erm genes (20, 34), which confer resistance to macrolides, lincosamides, and streptogramin B antimicrobial agents. This latter phenotype can be constitutive, generally mediated by the ermB gene, or inducible, generally mediated by the ermA subclass TR (ermA) gene (31). Other mechanisms of resistance to macrolides or lincosamides in S. pyogenes (e.g., mutations in ribosomal proteins) are infrequently involved and currently have little clinical impact (4, 17).The factor most directly associated with the increase in antimicrobial resistance is the high level of antibiotic consumption among the population (2, 15). Nonetheless, the final cause of a higher or lower prevalence of antimicrobial resista...

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Characterisation of the main clones of Streptococcus pyogenes carrying the ermA (subclass TR) gene in Spain

Cited by 9 publications

References 28 publications

Macrolide and Tetracycline Resistance andemmType Distribution ofStreptococcus pyogenesIsolates Recovered from Turkish Patients

Macrolide and Tetracycline Resistance andemmType Distribution ofStreptococcus pyogenesIsolates Recovered from Turkish Patients

Changing Epidemiology of Streptococcus pyogenes emm Types and Associated Invasive and Noninvasive Infections in Southern Taiwan

Phenotypic and Genotypic Characterization of Streptococcus pyogenes Isolates Displaying the MLS _B Phenotype of Macrolide Resistance in Spain, 1999 to 2005

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Characterisation of the main clones of Streptococcus pyogenes carrying the ermA (subclass TR) gene in Spain

Cited by 9 publications

References 28 publications

Macrolide and Tetracycline Resistance andemmType Distribution ofStreptococcus pyogenesIsolates Recovered from Turkish Patients

Macrolide and Tetracycline Resistance andemmType Distribution ofStreptococcus pyogenesIsolates Recovered from Turkish Patients

Changing Epidemiology of Streptococcus pyogenes emm Types and Associated Invasive and Noninvasive Infections in Southern Taiwan

Phenotypic and Genotypic Characterization of Streptococcus pyogenes Isolates Displaying the MLS B Phenotype of Macrolide Resistance in Spain, 1999 to 2005

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Phenotypic and Genotypic Characterization of Streptococcus pyogenes Isolates Displaying the MLS _B Phenotype of Macrolide Resistance in Spain, 1999 to 2005