Macrolide resistance in Streptococcus pyogenes: prevalence, resistance determinants, and emm types

Michos, Athanasios; Bakoula, Chrysanthi G.; Braoudaki, Maria; Koutouzi, Foteini I.; Roma, Elefthería; Pangalis, A.; Nikolopoulou, Georgia; Kirikou, E.; Syriopoulou, Vassiliki

doi:10.1016/j.diagmicrobio.2009.03.004

Cited by 53 publications

(56 citation statements)

References 30 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: Discussioncontrasting

confidence: 38%

“…The increasing rates of macrolide resistance in S. pyogenes have been reported from different parts of the world. 26 There are two main phenotypes of macrolide resistance in S. pyogenes: the M phenotype (efflux-mediated), mediated by the mef genes, which confers low levels of resistance to 14-and 15-membered macrolides but not to 16-membered macrolides, lincosamides, or streptogramin B; and the macrolidelincosamide-streptogramin B (MLS) phenotype, mediated by the erm genes, which confers resistance to macrolides, lincosamides, and streptogramin B antibiotics. This latter phenotype can be constitutive (cMLS), which is generally mediated by the erm(B) gene, or inducible (iMLS), which is generally mediated by the erm(A) subclass TR gene.…”

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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: Discussioncontrasting

confidence: 38%

mentioning

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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“…The differences of clarithromycin antimicrobial susceptibility pattern also indicated that no respiratory tract-associated Streptococcus pyogenes were not spread from respiratory tract-associated Streptococci. The clarithromycin-resistant gene (phage-associated gene) is not easily deleted generally [12].…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Respiratory Tract-Associated Streptococcus pyogenes at General Japanese Hospital in 2014

Minami¹,

Sakakibara²,

Imura³

et al. 2015

JBM

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Streptococcus pyogenesis most popularpathogen caused respiratory tract infection disease. This study was conducted to find out the recent clinical characteristics of Streptococcus pyogenes isolates from respiratory tract at Japanese hospital in 2014. Streptococcus pyogenes was identified by standard laboratory procedure. Antimicrobial susceptibility testing was performed by micro dilution assay according to CLSI recommendation. Respiratory tract isolates were defined as isolation from pharynx, nasal discharge, tonsillar, and sputum. Total one hundred sixty-one Streptococcus pyogenes were isolated among which 136 were from respiratory tract and 25 were from non-respiratory tract. Respiratory tract-associated Streptococcus pyogenes was isolated among which 102 were from male and 59 were from female. The age incidence among 0 -1 years age group was 8, among 1 -18 years age group, 131 (p < 0.01), among 19 -64 years age group, 17 (p < 0.01), and in 65-years it was 5. Although we investigated the relationship between season and bacterial isolation, we did not find any significant differences between respiratory tract and no respiratory tract isolation. However, our study revealed that clarithromycin was less antimicrobial effective in respiratory tract disease than in no respiratory tract disease significantly (p < 0.01). Although several antibiotics such as penicillin are still effective against Streptococcus pyogenes, incidence of Streptococcus pyogenes infection is not decreasing worldwide. Our study suggests the need for continuous epidemiological surveillance of Streptococcus pyogenes.

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“…Antibiotic resistance: Increasing antimicrobial resistance of GAS has been observed during the last decade in Europe and worldwide. 29 In 1992, Seppala et al, reported a high rate of erythromycin resistance(>45%) in Finland. 30 High frequencies of Erythromycin resistance have also been reported from Spain (21.3%), Italy (22.6%), Greece (24%), France (22.4%), Portugal (26.6%)and USA(32%).…”

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confidence: 99%

4. Pharyngeal carriage of Group A streptococci among school children

Mukundan¹,

Vijayakumar²

2017

JIMD

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Abstract:Objectives: The aims of the study were to determine the pharyngeal carriage rate of Group A streptococci among school children at Thrissur, Kerala and to determine the antibiotic sensitivity pattern of the above isolates. Materials and methods: Throat swabs were collected from a total of 260 asymptomatic children(130 each from rural and urban areas) of eighth and ninth standard classes during a period between July 2012 and July 2013. Presumptively identified Group A Streptococci (GAS/Streptococcus pyogenes) were serogrouped by agglutination tests using specific antisera. Antibiotic sensitivity was performed by disc diffusion method following CLSI guidelines. Results: The GAS carriage rate noted in the study was 23.1%. Carriage distribution was found to be independent of age, sex and locality with more number of cases during winter season. All the isolates were found to be sensitive to Penicillin and Vancomycin. Five isolates each were found to be resistant to Erythromycin and Clindamycin respectively. Inducible Clindamycin resistance was demonstrated in three of them. GAS was isolated from the throat swab of one child with past history of joint pains and another child with past history of skin infection-both of them presently had findings of heart disease. Conclusion: When screened and appropriately treated with antibiotics, carriers can be prevented from spreading streptococcal infections in the school environment and the community. Combined efforts by clinicians, community health personnel and clinical microbiologists are required for the early detection and control of streptococcal infections. .

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Macrolide resistance in Streptococcus pyogenes: prevalence, resistance determinants, and emm types

Cited by 53 publications

References 30 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

Clinical Characteristics of Respiratory Tract-Associated Streptococcus pyogenes at General Japanese Hospital in 2014

4. Pharyngeal carriage of Group A streptococci among school children

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