Macrolide resistance and genotypic characterization of Streptococcus pneumoniae in Asian countries: a study of the Asian Network for Surveillance of Resistant Pathogens (ANSORP)

Abstract

Data confirm that macrolide resistance in pneumococci is a serious problem in many Asian countries.

Emergence of a Unique Multiply-Antibiotic-Resistant Streptococcus pneumoniae Serotype 7B Clone in Dhaka, Bangladesh

“…The predominance of the MLS B phenotype (resistance to all macrolides, lincosamides, and streptogramin B)/erm(B) genotype in our study is consistent with recent findings from Sri Lanka, Korea, China, Taiwan, Japan, Spain, Italy, France, and South Africa (6,9,15,17). All strains with the MLS B phenotype exhibited a partially macrolide-inducible iMcLS B phenotype, i.e., they were susceptible or had intermediate resistance to rokitamycin and had no resistance induction to rokitamycin in the presence of erythromycin (13).…”

“…Our observation of a high level of resistance to sulfamethoxazole-trimethoprim in Bangladesh is consistent with findings from the mid-1990s (16). In contrast, the rates of resistance to penicillin G, macrolides, and other drugs are relatively low compared to those described in recent reports from other Asian countries, except India (8,17,18). Multiplyresistant S. pneumoniae is a problem in Bangladesh.…”

“…However, the global emergence of antimicrobial resistance in S. pneumoniae is a serious concern (4). Recent data from 12 Asian countries showed high resistance rates (17,18). We studied prospective resistance to a large number of antimicrobial agents in pneumococcal isolates.…”

High Prevalence of Antimicrobial Resistance among Clinical Streptococcus pneumoniae Isolates in Asia (an ANSORP Study)

“…On the basis of the distributions of the MICs for erythromycin-resistant strains and the rate of resistance to clindamycin in this study, the MLS B phenotype is predominant in Korea, China, Taiwan, Vietnam, and Hong Kong. Molecular characterization of macrolide-resistant strains from Asia showed that the erm(B) gene was found in more than 50% of pneumococcal isolates either singly or dually with the mef(A) gene in Korea, China, Vietnam, and Taiwan (30). Recently, clinical failures of macrolide treatment for pneumococcal infections caused by macrolideresistant strains have been reported (19,24).…”

Macrolide combination antibiotic therapy should be prudently considered in complicated CAP cases and in regions with low macrolide susceptibility

“…Erythromycin susceptibility is \20% in Taiwan and Korea, and about 25% in Hong Kong and China [2]. Macrolideresistant strains (ermB and mefA) are widely circulating in Asia.…”