High Prevalence of the
            <i>ermB</i>
            Gene among Erythromycin-Resistant
            <i>Streptococcus pneumoniae</i>
            Isolates in Germany during the Winter of 2000-2001 and In Vitro Activity of Telithromycin

Kresken, Michael; Henrichfreise, Beate; Bagel, Simone; Brauers, J.; Wiedemann, B.

doi:10.1128/aac.48.8.3193-3195.2004

Cited by 27 publications

(24 citation statements)

References 19 publications

(20 reference statements)

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“…Another important observation of the present study was the predominance of isolates displaying the M phenotype and harbouring the mef(A) ⁄ (E) gene. This is in contrast with the data from most other European countries, where the spread of macrolide resistance is associated mainly with erm-positive strains [28][29][30][31][32][33]. However, the M resistance phenotype, mediated by the mef(A) ⁄ (E) gene, is predominant among macrolide-resistant pneumococci in Canada [34] and the USA [27].…”

Section: Discussioncontrasting

confidence: 75%

Characterisation of macrolide-non-susceptible Streptococcus pneumoniae colonising children attending day-care centres in Athens, Greece during 2000 and 2003

Souli

Volonakis

Kapaskelis

et al. 2007

Clinical Microbiology and Infection

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Nasopharyngeal Streptococcus pneumoniae isolates colonising young children are representative of isolates causing clinical disease. This study determined the frequency of macrolide-non-susceptible pneumococci, as well as their phenotypic and genotypic characteristics, among pneumococci collected during two cross-sectional surveillance studies of the nasopharynx of 2847 children attending day-care centres in the Athens metropolitan area during 2000 and 2003. In total, 227 macrolide-non-susceptible pneumococcal isolates were studied. Increases in macrolide non-susceptibility, from 23% to 30.3% (p <0.05), and in macrolide and penicillin co-resistance, from 3.4% to 48.6% (p <0.001), were identified during the study period. The M resistance phenotype, associated with the presence of the mef(A)/(E) gene, predominated in both surveys, and isolates carrying both mef(A)/(E) and erm(AM) were identified, for the first time in Greece, among the isolates from the 2003 survey. Pulsed-field gel electrophoresis analysis of the isolates from the 2000 survey indicated the spread of a macrolide- and penicillin-resistant clone among day-care centres. The serogroups identified most commonly in the study were 19F, 6A, 6B, 14 and 23F, suggesting that the theoretical protection of the seven-valent conjugate vaccine against macrolide-non-susceptible isolates was c. 85% during both study periods.

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Section: Discussioncontrasting

confidence: 75%

Characterisation of macrolide-non-susceptible Streptococcus pneumoniae colonising children attending day-care centres in Athens, Greece during 2000 and 2003

Souli

Volonakis

Kapaskelis

et al. 2007

Clinical Microbiology and Infection

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show abstract

“…Although telithromycin showed excellent activity against all pneumococcal isolates, the MICs for macrolide‐resistant isolates were increased in comparison to macrolide‐susceptible isolates, indicating that resistance to erythromycin influences the potency of telithromycin. An increased telithromycin MIC has not been shown to be clinically relevant [31–33]; in the current study, all erythromycin‐resistant isolates were highly susceptible to telithromycin, irrespective of the mechanism of resistance. Although telithromycin is considered to be a poor substrate for the efflux pump [34], mef‐ positive isolates had higher telithromycin MICs than erm (B)‐positive isolates, which is in agreement with other published data [35,36], but the mechanism involved is unknown.…”

Section: Discussionmentioning

confidence: 57%

In-vitro susceptibility and molecular characterisation of macrolide resistance mechanisms among Streptococcus pneumonia isolates in The Netherlands: the DUEL 2 study

Neeleman

Valk

Klaassen

et al. 2005

Clinical Microbiology and Infection

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In total, 881 presumptive clinical isolates of Streptococcus pneumoniae collected from throughout The Netherlands were analysed to determine their mechanisms of macrolide resistance. Isolates were identified initially by participating laboratories using their own standard identification technique, followed by determination of MICs with Etests. Only 797 isolates were confirmed as pneumococci following bile-solubility tests, lytA PCR and 16S rRNA sequencing. Of these confirmed pneumococci, 59 (7.4%) isolates were macrolide-resistant. Analysis by PCR indicated that 34 (57.6%) isolates harboured only the erm(B) gene and 16 (27.1%) only the mef gene. Three (5.1%) isolates carried both erm(B) and mef, while six (10.2%) isolates were negative for both mechanisms. Of the six negative isolates, three had a mutation in the 23S rRNA gene, and three were negative for all mechanisms tested. No isolates with the erm(A) subclass erm(TR) gene were detected. Among the 19 mef-positive isolates, 14 (73.7%) carried the mef(A) gene, and only five (26.3%) carried the mef(E) gene. No linezolid cross-resistance or multiresistance (resistance to more than two classes of antibiotics) was observed.

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“…Methylation of the ribosomal drug binding site, which confers resistance to macrolides, lincosamides, and streptogramin group B (MLSB) may be inducibly or constitutively expressed (Leclercq, 2002). Previously, the most prevalent mechanism of macrolide resistance was also associated with ermB gene in Streptococcus pneumoniae (Kresken et al, 2004;Reinert et al, 2008). Drug efflux conferring low-level resistance to erythromycin but not clindamycin, encoded by the mefA gene, was not detected in this study.…”

Section: Arg Screeningmentioning

confidence: 60%

Screening for phenotypic and genotypic resistance to antibiotics in Gram positive pathogens

Farkas¹,

Tarco²,

Crăciunaş³

et al. 2017

Studia UBB Biologia

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SUMMARY.Gram positive bacteria such as methicillin resistant Staphylococcus aureus, vancomycin resistant enterococci or multidrug resistant Streptococcus spp. are increasingly involved in severe infections with serious clinical consequences. The aim of this study is to investigate phenotypic and genotypic resistance traits in Gram positive pathogens isolated from clinical specimens in Cluj-Napoca, Romania. A total number of 31 Enterococcus spp., Staphylococcus spp. and Streptococcus spp. strains were subjected to antimicrobial susceptibility testing by disc diffusion, while the carriage of 26 antibiotic resistance genes and of class 1 integron was assessed by PCR. Bacterial pathogens included in this study were mostly susceptible to folate pathway inhibitors (100%), oxazolidinones (97%), fosfomycins (93%) and glycopeptides (92%). Enterococci, staphylococci and streptococci displayed high levels of phenotypic resistance to penicillins, tetracyclines and macrolides, a percentage of 42% being multidrug resistant. The strains under this study proved to be able to produce β-lactamase enzymes encoded by the TEM-1 gene and aminoglycoside modifying enzymes due to the carriage of aac(6')-Ie-aph(2") gene, to possess ribosomal protection mechanisms for macrolide and tetracycline resistance associated with ermB, ermC and tet(M) genes and to bear efflux genes tet(A), tet(B), tet(C) ant tet(L). Class 1 integron integrase was detected in 16% of the isolates, but no significant correlations were found between the carriage of intI1 gene and the phenotypic or genotypic resistance among the Gram positive pathogens investigated.

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High Prevalence of the ermB Gene among Erythromycin-Resistant Streptococcus pneumoniae Isolates in Germany during the Winter of 2000-2001 and In Vitro Activity of Telithromycin

Cited by 27 publications

References 19 publications

Characterisation of macrolide-non-susceptible Streptococcus pneumoniae colonising children attending day-care centres in Athens, Greece during 2000 and 2003

Characterisation of macrolide-non-susceptible Streptococcus pneumoniae colonising children attending day-care centres in Athens, Greece during 2000 and 2003

In-vitro susceptibility and molecular characterisation of macrolide resistance mechanisms among Streptococcus pneumonia isolates in The Netherlands: the DUEL 2 study

Screening for phenotypic and genotypic resistance to antibiotics in Gram positive pathogens

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