Molecular detection of genes responsible for macrolide resistance among Streptococcus pneumoniae isolated in North Lebanon

Abstract

In recent years, the increased use of macrolides was linked with the emergence of resistance Streptococcus pneumoniae worldwide. The main aim of this study was to determine the prevalence of S. pneumoniae resistant to macrolides and to identify the macrolide resistance genotypes among clinical isolates collected in North Lebanon. Disk diffusion susceptibility method was performed for 132 strains of S. pneumoniae isolated over a period of 5 years in North Lebanon. Polymerase Chain Reaction followed by pyrosequencing was carried out for confirmation of phenotypic diagnosis. The macrolide resistance genotypes were also identified by using PCR amplification of genes implicated in this resistance: erm(A), erm(B), erm(C), msr(A), lin(A) and mef(A/E). Macrolide resistance was found in 34.1% of S. pneumoniae isolates. We observed that the cMLS phenotype (31/45, 68.9%) was the most common in these pneumococci and erm(B) was the most common resistance gene (32/45, 71.1%). This study shows that macrolide resistance in S. pneumoniae in North Lebanon is mainly related to target site modification with predominance of cMLSb phenotype but is also mediated by efflux pumps. lin(A) gene was reported for the first time in one S. pneumoniae strain in combination with erm(B) and mef(A/E) genes.

Molecular characterization, antibiotic resistance pattern and capsular types of invasive Streptococcus pneumonia isolated from clinical samples in Tehran, Iran

“…In agreement with this finding, other studies in the Turkey, China and Taiwan showed that the ermB gene was the most frequent macrolide resistance determinant. while the most common resistance gene in the Canada and United States was mefA/E gene [20,21]. In this study the rate of co resistance related to ermB and mefA/E gens was found in 23% of isolates which accordance with a report from Turkey (20%) [20].…”

“…As for frequency of double resistance to erythromycin and clindamycin has been spread globally. The high prevalence of dual resistance in S. pneumoniae was found in South Korea and South Africa [5,21,22].…”

First data on antimicrobial susceptibility patterns of Moraxella catarrhalis isolates in Lebanon

“…Surprisingly, two studies conducted in Ethiopia and Pakistan showed high level of resistance to ciprofloxacin, with 16.2% and 59% respectively [13,20]. Indeed, our generated data are in accordance with recent national studies reporting an increased level of antimicrobial resistance among infectious bacterial agents, a striking low level of antibiotic awareness among Lebanese population, a spread of counterfeit medicines, and a misuse of antibiotics in Lebanon [6][7][8][9][10][11][26][27][28][29][30][31][32]. Even if this study provides useful information for physicians to develop effective empirical antibiotic treatment for M. catarrhalis infections, we advise to pay attention to this prominent issue and we recommend the implementation of reliable identification and antibiotic susceptibility testing in routine laboratory diagnostics to guide appropriate treatment.…”

Antibacterial Effect of Zinc Oxide Nanoparticles on Group A β-Hemolytic Streptococci with Macrolide Resistance Isolated from University Student Carriers in North of Iran

“…The results of the current study, which was carried out in line with similar studies conducted in Germany (9), the UK (29), and Iran (30), confirmed that most erythromycin-resistant samples harbored mefA gene. A study by Kargar et al showed a significant relationship between erythromycin resistance and the frequency of mefA gene harboring (31); also, D'Ercole et al screened 124 S. pyogenes isolates for the presence of mef (A) and the frequency was reported as 25.8% (32); while in North Lebanon only 2.2% of isolates harbored mefA gene (33). These findings revealed that the prevalence of resistant bacteria harboring mef gene is rising in most countries.…”