Phenotypic and genotypic characterization of macrolide-resistant group A Streptococcus strains in the province of Quebec, Canada

“…Erythromycin-resistant GAS in this setting accounted for 48% of the GAS isolates recovered. In addition, Weiss et al reported the predominance of an erythromycinresistant M28 (65% of erythromycin-resistant isolates were M28) in patients presenting with pharyngitis in 1998, and in Ontario in 1997 de Azavedo found that an M4 serotype accounted for 28% of the erythromycin-resistant strains studied (7,26). What is interesting in our study is the observation that a particular erythromycin-resistant M type, e.g., MPT2967, can predominate early on and gradually diminish in prevalence over a period of 2 to 3 years, similar to what is seen for other non-erythromycin-resistant M types.…”

Section: Discussionmentioning

confidence: 99%

Invasive Group A Streptococcal Disease in Alberta, Canada (2000 to 2002)

et al. 2005

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Invasive group A streptococcal (iGAS) disease was placed under surveillance in Alberta in August 1999. The purpose of this study was to determine the incidence rates of iGAS infections throughout Alberta over a 3-year period (2000 to 2002) and to better understand the epidemiology of iGAS in this province. There were a total of 441 cases of invasive GAS disease over the 3 years examined (average population over 3

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“…In the case of S. pyogenes, published results appear conflicting, since sometimes they attribute a role to antibiotic use in the level of resistance (4,11,25,29,30), but sometimes they do not (26,34). The fact that only a few clones seem to drive resistance to erythromycin makes clonal spread a variable worth considering (M12 in Japan and M4 and M75 in Spain and Finland).…”

Section: Discussionmentioning

confidence: 99%

Pharmacoepidemiological Analysis of Provincial Differences between Consumption of Macrolides and Rates of Erythromycin Resistance among Streptococcus pyogenes Isolates in Spain

et al. 2002

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The M phenotype is by far the most common mechanism of erythromycin resistance among Streptococcus pyogenes isolates in Spain. A geographic analysis of the relationship between within-country differences in the prevalence of M-type resistance to erythromycin in S. pyogenes and the level of consumption of 14-and 15-membered macrolides within different provinces was carried out. From 1998 to 1999, a nationwide multicenter surveillance study yielded 2,039 consecutive pharyngeal isolates of S. pyogenes. Data on antibiotic consumption for the same period were gathered from IMS Health, and the corresponding daily defined doses per 1,000 inhabitants per day were calculated according to the Anatomic Therapeutic Classification index. Macrolide use was subdivided into dosages given three times a day (TID), twice a day (BID), or once a day (OD). Spearman nonparametric correlation coefficients (R) were calculated, and variables proving to be significantly associated (P < 0.1) were introduced into a linear regression model. The total consumption of macrolides presented a significant correlation with the prevalence of resistance (R ‫؍‬ 0.527; P ‫؍‬ 0.032). Neither TID nor BID macrolide consumption showed significant correlations. Only OD consumption had a significance below 0.1. These data are consistent with the hypothesis that only the total consumption of macrolides influences the local rates of M-type erythromycin resistance in S. pyogenes, and subgroups of macrolides seem to have an additive rather than a selective effect by contributing to increasing the final amount of macrolides used. Local variations in total consumption were associated only with BID consumption (R ‫؍‬ 0.849; P ‫؍‬ 0.004). The simple linear regression with total macrolide consumption showed a considerable determination coefficient (R 2 ‫؍‬ 0.678; P ‫؍‬ 0.006). The model explains up to 68% of the measured variation and is clearly better as a predictor of the prevalence of resistance than the mere mean is. By solving the regression equation, the resultant value of 2.2 defined doses per 1,000 inhabitants per day fits with the existence of a critical threshold of selective pressure.

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Phenotypic and genotypic characterization of macrolide-resistant group A Streptococcus strains in the province of Quebec, Canada

Cited by 34 publications

References 11 publications

Erythromycin-Resistant Group A Streptococcal Isolates Collected between 2000 and 2005 in Oahu, Hawaii, and Their emm Types

Erythromycin-Resistant Group A Streptococcal Isolates Collected between 2000 and 2005 in Oahu, Hawaii, and Their emm Types

Invasive Group A Streptococcal Disease in Alberta, Canada (2000 to 2002)

Pharmacoepidemiological Analysis of Provincial Differences between Consumption of Macrolides and Rates of Erythromycin Resistance among Streptococcus pyogenes Isolates in Spain

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