Emergence and Spread ofStreptococcus pneumoniaewitherm(B) andmef(A) Resistance

Farrell, David J.; Jenkins, Stephen G.; Brown, Steven D.; Patel, Manish; Lavin, Bruce; Klugman, Keith P.

doi:10.3201/eid1106.050222

Cited by 110 publications

(114 citation statements)

References 37 publications

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“…In Germany, Bley et al (18) reported the presence of combined erm (B)+mef (A) genotype in 4.1% of pneumococcal isolates. Similar results have been increasingly reported in North America, South Asia and South Africa during the last decade (17,19). In Russia, dual resistance genes among isolates collected between 2003 and 2005 were found in 30.3% (20).…”

Section: Discussionsupporting

confidence: 74%

“…Although Telli et al (16) reported higher percentages (40%) in 2007-2009, the macrolide resistance rate in this study was 22.5%, which is similar to the result of EARRSS, but higher than the rates reported previously in our hospital (13,14). S2 S3 S11 S13 S18 S6 S15 S16 S17 S4 0.1 0.2 (17). In Germany, Bley et al (18) reported the presence of combined erm (B)+mef (A) genotype in 4.1% of pneumococcal isolates.…”

Section: Discussioncontrasting

confidence: 46%

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Phenotypes and Genotypes of Macrolide-Resistant Streptococcus Pneumoniae

Sirekbasan¹,

Gönüllü²,

Sirekbasan³

et al. 2015

Balkan Med J

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Streptococcus pneumoniae (S. pneumoniae) is a major pathogen of bacterial pneumonia, meningitis, sinusitis and otitis media. Antimicrobial resistance in S. pneumoniae, including macrolide resistance, has been a growing problem in recent years due to the increasing numbers of cases with treatment failures of infections caused by macrolide-resistant pneumococci (1).Macrolide resistance in S. pneumoniae is mediated by: the erm (B) gene encodes methylation of the ribosomal macrolide target sites and mef (A) encodes the drug efflux. Deterioration of riboproteins L4 and L22 and mutations in the 23S rRNA genes are involved in the other less common mechanisms (2).In this study, we analyzed the distribution of the phenotypes, genotypes, and clonal relatedness of macrolide-resistant S. pneumoniae strains isolated in our hospital. MATERIALS AND METHODSEighty S. pneumoniae strains were collected between January 2008 and September 2009 in the Department of Microbiology of the Cerrahpaşa Faculty of Medicine. Ethics committee approval was received for this study from the Ethics Committee of Cerrahpaşa Faculty of Medicine. Strains were isolated mostly from sputum. The remaining isolates were from tracheal aspirates, bronchoalveolar lavage fluid, nasal swab and blood culture.S. pneumoniae isolates were identified based on conventional microbiological methods. Antibiotic susceptibility testing was performed with the disc diffusion method (3).Macrolide resistance phenotypes were determined by Montanari et al. (4) : 11.11.2013 Accepted: 23.11.2014 • DOI: 10.5152/balkanmedj.2015 Available at www.balkanmedicaljournal.org Cite this article as: Sirekbasan L, Gönüllü N, Sirekbasan S, Kuşkucu M, Midilli K. Phenotypes and genotypes of macrolide-resistant streptococcus pneumoniae. Balkan Med J 2015;32:84-8. Copyright 2015 © Trakya University Faculty of MedicineBalkan Med J 2015;32:84-8 Original Article | 84MICs of macrolides (erythromycin, clarithromycin and azithromycin), lincosamides (clindamycin), streptogramins (quinupristin-dalfopristin) and penicillin G were measured by E-test (AB Biodisk; Solna, Sweden). The strain S. pneumoniae ATCC 49619 was used as a control strain. Detection of erythromycin-resistance genesA PCR method was used for the detection of erythromycinresistance genes (5). Bacterial DNA was isolated using a DNA isolation kit (Roche Diagnostic; Mannheim, Germany). All PCR mixtures contain a volume of 25 µL with 5µL of target DNA, 0.5 µL of each primer (25 mM), 1.5 µL of 25 mM MgCl 2 , 0.5 µL of dNTP mixture (25 mM each), 0.125 µL of Taq DNA polymerase (5 U/µL) and 2.5 µL of 10X buffer (MBI; Fermentas, Lithuania). PCR for both genes was performed on PTC-200 (Peltier Thermal Cycler; MJ Research, USA). Cycling conditions for amplification were: 5 min at 94°C, followed by 40 cycles of 1 min at 94°C, 1 min at 48°C and 1.5 min at 72°C, with a final 10 min incubation at 72°C. PCR products were separated on ethidium bromide stained 1.5% agarose gels. The expected sizes of amplification products for erm (B) and mef (A) were ...

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Section: Discussionsupporting

confidence: 74%

Section: Discussioncontrasting

confidence: 46%

Phenotypes and Genotypes of Macrolide-Resistant Streptococcus Pneumoniae

Sirekbasan¹,

Gönüllü²,

Sirekbasan³

et al. 2015

Balkan Med J

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“…Three of these isolates had very high levels of resistance to beta-lactam antibiotics (MICs of 8 g/ml for both penicillin and amoxicillin). It will be interesting to determine whether these multiresistant isolates carry both ermB and mefA determinants, as do other strains closely related to Taiwan 19F -14 that were recently characterized in a global study of community-acquired respiratory tract infections (10).…”

Section: Resultsmentioning

confidence: 99%

Pre- and Postvaccination Clonal Compositions of Invasive Pneumococcal Serotypes for Isolates Collected in the United States in 1999, 2001, and 2002

et al. 2006

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“…People infected with an antibiotic-resistant organism are more likely to have longer hospital stays and require treatment with second-or third-line drugs that may be less effective, more toxic and more expensive (Farrell et al, 2005;Levy, 2005).…”

Section: Introductionmentioning

confidence: 99%

Public Knowledge and Attitudes Regarding Antibiotic Use in South Korea

2011

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Purpose: This study was conducted to examine public level of knowledge and attitudes regarding antibiotic use and potential drug resistance. Methods: A cross-sectional face-to-face survey of 1,177 residents aged 18 or over was conducted in Korea. A quota sampling method was used. Results: Most respondents (70%) did not know that antibiotics are ineffective in treating coughs and colds. Two-thirds of the respondents were unaware of the conditions under which antibiotic resistance occurs, despite understanding the concept of resistance. Lower education level and older age were independently associated with inadequate knowledge. Lower education level, older age, inadequate knowledge and no exposure to the education campaign were independently associated with poor attitude. Conclusion: The results of this study demonstrate that the general public has misunderstandings and a lack of knowledge with regard to antibiotic use, despite a national educational campaign. However, the campaign may have had an effect on the public's attitudes towards antibiotics.

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Emergence and Spread ofStreptococcus pneumoniaewitherm(B) andmef(A) Resistance

Cited by 110 publications

References 37 publications

Phenotypes and Genotypes of Macrolide-Resistant Streptococcus Pneumoniae

Phenotypes and Genotypes of Macrolide-Resistant Streptococcus Pneumoniae

Pre- and Postvaccination Clonal Compositions of Invasive Pneumococcal Serotypes for Isolates Collected in the United States in 1999, 2001, and 2002

Public Knowledge and Attitudes Regarding Antibiotic Use in South Korea

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