Macrolide resistance mechanisms among Streptococcus pneumoniae isolated over 6 years of Canadian Respiratory Organism Susceptibility Study (CROSS) (1998 2004)

Wierzbowski, Aleksandra; Nichol, Kim; Laing, Nancy M.; Hisanaga, Tamiko; Nikulin, A.; Karlowsky, James A.; Hoban, Daryl J.; Zhanel, George G.

doi:10.1093/jac/dkm273

Cited by 51 publications

(42 citation statements)

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“…More than 50% of the macrolide-resistant population were erm (B)+mef (A) positive (23). In Canada, erm (B) and mef (A) positive isolates represent 4% in 1998 and 12% in 2004 and one major cluster containing 36 (72%) of the 50 isolates was described (24).…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

Phenotypes and Genotypes of Macrolide-Resistant Streptococcus Pneumoniae

Sirekbasan¹,

Gönüllü²,

Sirekbasan³

et al. 2015

Balkan Med J

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“…DNA hybridization analysis of the 23S rRNA genes in S. criceti strains As mutations of the 23S rRNA genes and the rplD gene of S. pneumoniae are associated with resistance to macrolides (Tait-Kamradt et al, 2000;Wierzbowski et al, 2007), we first examined the 23S rRNA genes (rrl genes) of the four S. criceti strains by DNA hybridization. Genome sequence analysis of strain HS-6 T indicated that the genome contains five rrl genes and that five fragments, 12.8, 9.4, 9.2, 7.9 and 7.1 kb in size, should be detected after EcoRI digestion, whereas five fragments, 7.4, 6.0, 5.3, 3.8 and 3.3 kb in size, should be detected after EcoRI and BbsI double digestion (Richards Fig.…”

Section: Susceptibility Of S Criceti Strains To Antibioticsmentioning

confidence: 99%

“…Macrolide resistance in S. pneumoniae, a mitis group member, is mediated by the mef(A) gene encoding a macrolide efflux pump or by the erm(B) gene encoding a ribosomal RNA methylase (Wierzbowski et al, 2007), which methylates the N-6 position of nucleotide A2058, in Escherichia coli numbering, in 23S rRNA domain V Edited by Kazuhiro Kutsukake * Corresponding author. E-mail: htamura@iwate-med.ac.jp Note: Nucleotide sequence data reported are available in the DDBJ/EMBL/GenBank databases under the accession numbers AB981371−AB981373 and LC009004−LC009006.…”

Section: Introductionmentioning

confidence: 99%

“…DOI: http://doi.org/10.1266/ggs.15-00038 (Takaya et al, 2013). Furthermore, mutations in the 23S rRNA genes and the rplD gene encoding the ribosomal protein L4 have been found in clinical isolates and laboratory-generated mutants of macrolide-resistant S. pneumoniae (Tait-Kamradt et al, 2000;Wierzbowski et al, 2007). Of note is that mutation of A2058 in the 23S rRNA gene confers resistance to macrolide, lincosamide and streptogramin type B in S. pneumoniae as well as in E. coli, Helicobacter pylori, Propionibacteria and Streptomyces ambofaciens (for review, see Vester and Douthwaite, 2001).…”

Section: Introductionmentioning

confidence: 99%

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Identification of A2059G 23S rRNA and G439A <i>rplC</i> gene mutations in <i>Streptococcus criceti</i> strain OMZ 61, a strain resistant to azithromycin, josamycin and clindamycin

2015

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Streptococcus criceti is a cariogenic organism that belongs to the mutans streptococci. Of the four S. criceti strains, strain OMZ 61 has been identified as being resistant to erythromycin. Antimicrobial susceptibility testing showed that strain OMZ 61 is also resistant to azithromycin, josamycin and clindamycin but susceptible to tetracycline and tiamulin. DNA hybridization analysis of the 23S rRNA genes revealed that the hybridization patterns in strain OMZ 61 differed from those in the other three strains. We further analyzed the nucleotide sequences of a ribosomal RNA operon, the rrnD operon, and the rpsJ−rpsQ region including rplC and rplD genes for ribosomal proteins L3 and L4, respectively, in the four strains studied. Nucleotide sequence analysis indicated that strain OMZ 61 contains an A-to-G substitution at nucleotide position 2059, equivalent to Escherichia coli numbering 2058, in a 23S rRNA gene (rrlD) and a G-to-A substitution at nucleotide position 439 in the rplC gene, suggesting an amino acid residue change at position 147 from valine to isoleucine, whereas no mutation in the rplD gene was found. DNA sequencing and polymerase chain reaction-restriction fragment length polymorphism analysis showed that most or all of the 23S rRNA genes in strain OMZ 61 contain the A2059G mutation. These findings suggest that the resistance to erythromycin, azithromycin, josamycin and clindamycin in strain OMZ 61 is conferred by alterations in 23S rRNA and/or ribosomal protein L3. This is the first description of mutations in the 23S rRNA and rplC genes in mutans streptococci.

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“…However, upper respiratory tract infections, injury, headache, back pain and hypoglycaemia are reported slightly more frequently than placebo in clinical trials 4 . To treat this upper respiratory tract infection, physicians usually prescribes macrolide like antibiotics 5 .…”

Section: Issn: 0975-8232mentioning

confidence: 99%

Untitled

2012

IJPSR

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Diabetes is a debilitating metabolic disorder characterized by chronically elevated blood glucose level above the normal range and affects mostly all kind of populations epidemiologically. Objectives: In clinical situations, diabetic patients already on prescription of Rosiglitazone are prone to bacterial infection. To cure such infection Clarithromycin is prescribed particularly in Respiratory Tract Infections. Materials and Methods: Diabetes was induced experimentally in overnight fasted Rats by intraperitoneal injection of Nicotinamide, 15 min prior to intraperitoneal injection of Streptozotocin (60 mg/kg). Nicotinamide (160 mg/kg) was freshly prepared by dissolving in distilled water and Streptozotocin was dissolved in freshly prepared 0.1M Citrate buffer. Since Rosiglitazone and Clarithromycin have found to exert minimal to mild toxicity in animals on these doses, i.e. 80 mg/kg and 400 mg/kg respectively, both these drugs were administered for 14 days to the animals to study the toxicity in diabetic condition. Parameters included for the study includes body weight changes, oral glucose tolerance test, biochemistry, hematology, urine analysis and histopathology. Results: Clarithromycin aggravated hyperglycemia and reduced platelet count in diabetic condition. Further, combination of both Rosiglitazone and Clarithromycin reduced hepatotoxicity and nephrotoxicity in diabetic condition. Clarithromycin and Rosiglitazone combination showed markedly decreased TGL levels indicating Rosiglitazone's additive adverse effect in diabetic as well as non-diabetic condition. Conclusion: Study inform about the two different class of drug which clinically can be used together. Though the combination has shown some promising effects on liver and renal functions in terms of Hepatotoxicity and Nephrotoxicity, concern about the reduced TGL and testicular toxicity cannot be over-looked and thus, further research is warned in this direction.

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Macrolide resistance mechanisms among Streptococcus pneumoniae isolated over 6 years of Canadian Respiratory Organism Susceptibility Study (CROSS) (1998 2004)

Abstract: The prevalence of efflux-based macrolide resistance in S. pneumoniae in Canada remained steady between 1998 and 2004. Macrolide resistance due to erm(B) decreased over the same time period, with a rapid increase in isolates with both erm(B) and mef(A) macrolide resistance.

Cited by 51 publications

References 32 publications

Phenotypes and Genotypes of Macrolide-Resistant Streptococcus Pneumoniae

Phenotypes and Genotypes of Macrolide-Resistant Streptococcus Pneumoniae

Identification of A2059G 23S rRNA and G439A <i>rplC</i> gene mutations in <i>Streptococcus criceti</i> strain OMZ 61, a strain resistant to azithromycin, josamycin and clindamycin

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