Macrolide resistance rates in respiratory pathogens in Slovenia following reduced macrolide use

Čižman, Milan; Beović, Bojana; Seme, Katja; Paragi, Metka; Štrumbelj, Iztok; Müller-Premru, Manica; Čad-Pečar, Silva; Pokorn, Marko

doi:10.1016/j.ijantimicag.2006.07.023

Cited by 13 publications

(7 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although we do not have information on antibiotic usage in the patients of this study, the observed decline in macrolide resistance rates seems to not correlate to general macrolide consumption. A recent study from Slovenia indicated even the opposite; that is, a boost in resistance rates among non-invasive GAS, despite a decrease in macrolide use [ 30 ]. Thus, besides the presumed association with antibiotic use, other underlying mechanisms influencing the development and spread of antibiotic-resistant GAS isolates are to be considered, such as natural fluctuations in the prevalence of resistant clones and low fitness costs of some erythromycin-resistant clones [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Decline in macrolide resistance rates among Streptococcus pyogenes causing pharyngitis in children isolated in Italy

Gherardi

Petrelli

Luca

et al. 2015

Eur J Clin Microbiol Infect Dis

View full text Add to dashboard Cite

Macrolides are often used to treat group A streptococcus (GAS) infections, but their resistance rates reached high proportions worldwide. The aim of the present study was to give an update on the characteristics and contemporary prevalence of macrolide-resistant pharyngeal GAS in Central Italy. A total of 592 isolates causing pharyngitis in children were collected in the period 2012–2013. Clonality was assessed by emm typing and pulsed-field gel electrophoresis (PFGE) for all macrolide-resistant strains and for selected susceptible isolates. Genetic determinants of resistance were screened by polymerase chain reaction (PCR). Forty-four GAS were erythromycin-resistant (7.4 %). Among them, 52.3 % and 50 % were clindamycin- and tetracycline-resistant, respectively. erm(B)-positive isolates (52.3 %) expressed the constitutive cMLSB phenotype. mef(A) and its associated M phenotype were recorded in 40.9 % of the cases. The remaining erm(A)-positive isolates expressed the iMLSB phenotype. Seventeen tetracycline-resistant isolates carried tet(M) and five isolates carried tet(O). Twenty-five emm types were found among all strains, with the predominance of emm types 12, 89, 1, and 4. Eleven emm types and 12 PFGE clusters characterized macrolide-resistant strains, with almost two-thirds belonging to emm12, emm4, and emm11. Macrolide-susceptible and -resistant emm types 12, 89, 11, and 4 shared related PFGE profiles. There was a dramatic decline in macrolide resistance in Central Italy among pharyngeal GAS isolates in 2012–2013 when compared to previous studies from the same region (p < 0.05), although macrolide consumption remained stable over the past 15 years. We observed a decrease in the proportion of macrolide-resistant strains within emm types commonly associated with macrolide resistance in the past, namely emm12, 1, and 89.

show abstract

Section: Discussionmentioning

confidence: 99%

Decline in macrolide resistance rates among Streptococcus pyogenes causing pharyngitis in children isolated in Italy

Gherardi

Petrelli

Luca

et al. 2015

Eur J Clin Microbiol Infect Dis

View full text Add to dashboard Cite

show abstract

“…A decrease in the use of macrolides has been reported for instance in Spain [18], Portugal [24,25], Belgium [26], Slovenia [27] and Taiwan [28,29]. The influence of a decreased macrolide consumption on macrolide susceptibility is discussed controversially.…”

Section: Discussionmentioning

confidence: 99%

Macrolide susceptibility and serotype specific macrolide resistance of invasive isolates of Streptococcus pneumoniae in Germany from 1992 to 2008

et al. 2010

View full text Add to dashboard Cite

BackgroundMacrolide resistant Streptococcus pneumoniae has been on a gradual increase in Germany for over a decade. The current study was undertaken against the background of the recent observation of declining macrolide resistance rates especially among German children. Nationwide surveillance of invasive pneumococcal disease has been conducted in Germany since 1992. A population- and laboratory-based approach was used to collect data on invasive pneumococcal disease, and isolates sent to the National Reference Center for Streptococci by diagnostic microbiological laboratories from 1992 to 2008 were included in this study.ResultsFrom 1992 to 2008, data on macrolide susceptibility were available for 11,807 invasive isolates. 8,834 isolates (74.8%) were from adults (≥ 16 years), and 2,973 isolates (25.2%) from children (< 16 years). The overall nonsusceptibility rate of all isolates was 16.2% (intermediate, 0.2%; resistant, 16.0%). Higher resistance rates were observed among children (intermediate, 0.2%; resistant, 23.8%) than among adults (intermediate, 0.3%; resistant 13.4%). Maximum nonsusceptibility rates during the period under study were observed in 2005 (children: intermediate, 0.3%; resistant, 32.3%; adults: intermediate, 0.0%; resistant, 18.6%), while nonsusceptibility rates in 2008 were considerably lower, especially for children (children: intermediate, 0.0%; resistant, 15.2%; adults: intermediate, 0.1%; resistant, 12.9%). The rate of resistance was higher among the vaccine serotypes (7-valent, 36.6%; 10-valent, 28.2%; 13-valent, 24.3%) than among the non vaccine serotypes (non 7-valent, 6.5%; non 10-valent, 7.4%; non 13-valent, 6.3%). Serotype 14 (69.6% nonsusceptibility) proved to be the most resistant serotype.ConclusionsThere has been a considerable and statistically significant decrease in macrolide nonsusceptibility in Germany since 2005, especially among children.

show abstract

“…Nonetheless, for S. pyogenes , these correlations are not always clear, primarily because of frequent clonal fluctuations for this organism. For instance, despite a 21% decrease in macrolide use in Slovenia, resistance doubled among noninvasive S. pyogenes isolates ( 10 ). …”

Section: The Studymentioning

confidence: 99%

Antimicrobial Drug Use and Macrolide-ResistantStreptococcus pyogenes, Belgium

Heirstraeten¹,

Coenen²,

Lammens³

et al. 2012

Emerg. Infect. Dis.

View full text Add to dashboard Cite

In Belgium, decreasing macrolide, lincosamide, streptogramins B, and tetracycline use during 1997–2007 correlated significantly with decreasing macrolide-resistant Streptococcus pyogenes during 1999–2009. Maintaining drug use below a critical threshold corresponded with low-level macrolide-resistant S. pyogenes and an increased number of erm(A)-harboring emm77 S. pyogenes with low fitness costs.

show abstract

Macrolide resistance rates in respiratory pathogens in Slovenia following reduced macrolide use

Cited by 13 publications

References 17 publications

Decline in macrolide resistance rates among Streptococcus pyogenes causing pharyngitis in children isolated in Italy

Decline in macrolide resistance rates among Streptococcus pyogenes causing pharyngitis in children isolated in Italy

Macrolide susceptibility and serotype specific macrolide resistance of invasive isolates of Streptococcus pneumoniae in Germany from 1992 to 2008

Antimicrobial Drug Use and Macrolide-ResistantStreptococcus pyogenes, Belgium

Contact Info

Product

Resources

About