Community-Based Surveillance in the United States of Macrolide-Resistant Pediatric Pharyngeal Group A Streptococci during 3 Respiratory Disease Seasons

Tanz, Robert R.; Shulman, Stanford T.; Shortridge, Virginia D.; Kabat, William; Kabat, Kathy; Cederlund, Emily; Rippe, Jason; Beyer, Jill; Doktor, Stella Z.; Beall, Bernard

doi:10.1086/426025

Cited by 71 publications

(55 citation statements)

References 43 publications

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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%

“…8,29,33,39 Low erythromycin resistance rates (0.6%-6.8%) were reported in some countries. 14,15,21,23,25,28,30,37 Our erythromycin resistance rate was similar to rates in the United States (9.6%), 19 Germany (12.7%), 4 and Greece 280 DUNDAR ET AL.…”

Section: Discussionsupporting

confidence: 62%

“…1,2 The M phenotype is the predominant phenotype in many countries, 7,15,19,34,37 whereas iMLS is the most common phenotype in some countries 4,14,25,30 . Differences among the countries could be due to different antibiotic using patterns.…”

Section: Discussionmentioning

confidence: 99%

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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%

Section: Discussionsupporting

confidence: 62%

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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 strains with emm28 showed a high ERY resistance rate (58.3%), suggesting that strains with this emm genotype are highly resistant. All erm(B)-positive ERY-resistant GAS isolates had an emm28 genotype, which accounts for 50% and 70% of erm(B)-positive ERY-resistant GAS isolates in North America [21] and France [6], respectively. In our previous study (2002), the ERY resistance rate of emm12 strains was 63%, and most of them had the cMLSB phenotype, whereas emm18 and emm75 strains had the M phenotype.…”

Section: Discussionmentioning

confidence: 99%

Decline in Erythromycin Resistance in Group A Streptococci from Acute Pharyngitis due to Changes in theemmGenotypes Rather Than Restriction of Antibiotic Use

Koh

Kim

2010

Ann Lab Med

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“…Azithromycin is the only drug that is given in a 5-day course as opposed to a 10-day course for all the other antibiotics. Although there are no strains of GAS resistant to penicillin, amoxicillin and cephalosporins, GAS susceptibility to macrolides varies depending on the region and the level of consumption, with the percentage of resistant strains reaching over 25% in some countries [59,60]. Since the susceptibility of the given GAS strain to macrolides is unpredictable, treatment with these drugs must be always preceded by performing antibiotic susceptibility test [7,28].…”

Section: Treatment Optionsmentioning

confidence: 99%

Management of acute streptococcal pharyngitis: still the subject of controversy

Mazur

2013

Open Medicine

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AbstractAlthough most cases of acute pharyngitis are viral in origin, antibiotics are overused in its treatment. Streptococcus pyogenes (group A streptococcus, GAS), the principal bacterial pathogen of acute sore throat, is responsible for merely 5–30% of cases. Moreover, GAS pharyngitis is currently the only commonly occurring form of acute pharyngitis for which antibiotic therapy is definitely indicated. Therefore the differentiation between GAS pharyngitis and that of viral etiology is crucial. Accordingly, scientific societies as well as respected advisory bodies in Europe and North America, issued guidelines for the management of acute pharyngitis with the aim of minimizing unnecessary antibiotic prescriptions in its treatment. The aim of this review work is to confront the state of the art in acute GAS pharyngitis diagnosis and treatment with different approaches to its management represented by current European and North American guidelines. Although based on scientific evidence, international guidelines differ substantially in opinions whether GAS pharyngitis diagnosis should be based on microbiological testing, clinical algorithm or a combination of both. On the other hand, some European guidelines consider GAS pharyngitis to be a mild, self-limiting disease that does not require a specific diagnosis or antimicrobial treatment except in high-risk patients. There is an agreement among guidelines that if antibiotic therapy is indicated, phenoxymethyl penicillin should be the drug of choice to treat GAS pharyngitis.

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Community-Based Surveillance in the United States of Macrolide-Resistant Pediatric Pharyngeal Group A Streptococci during 3 Respiratory Disease Seasons

Abstract: The macrolide resistance rate among pharyngeal GAS was <5% and was stable over the 3 seasons. However, rates varied among sites each year. There was no evidence of spread of a specific resistant clone, increasing clindamycin resistance, or escalation in median erythromycin MICs.

Cited by 71 publications

References 43 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

Decline in Erythromycin Resistance in Group A Streptococci from Acute Pharyngitis due to Changes in theemmGenotypes Rather Than Restriction of Antibiotic Use

Management of acute streptococcal pharyngitis: still the subject of controversy

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